12345...102030...


Coronavirus disease 2019 – Wikipedia

Infectious respiratory disease caused by severe acute respiratory syndrome coronavirus 2

Coronavirus disease 2019 (COVID-19) is a contagious respiratory and vascular[9][10] (blood vessel) disease. It is caused by becoming infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2),[11] which is a specific type of coronavirus. Common symptoms include fever, cough, fatigue, shortness of breath or breathing difficulties, and loss of smell and taste.[6] The incubation period, which is the time between becoming infected with the virus and showing symptoms, may range from one to fourteen days.[12] While most people have mild symptoms, some people develop acute respiratory distress syndrome (ARDS) possibly precipitated by cytokine storm,[13] multi-organ failure, septic shock, and blood clots. Longer-term damage to organs (in particular lungs and heart) has been observed, and there is concern about a significant number of patients who have recovered from the acute phase of the disease but continue to experience a range of effectsincluding severe fatigue, memory loss and other cognitive issues, low grade fever, muscle weakness, breathlessness, and other symptomsfor months afterwards.[14][15][16][17]

COVID-19 spreads most often when people are physically close.[a] It spreads very easily and sustainably through the air, primarily via small droplets or aerosols, as an infected person breathes, coughs, sneezes, sings, or talks.[19][20] It may also be transmitted via contaminated surfaces, although this has not been conclusively demonstrated.[20][21][22] Airborne transmission from aerosol formation is suspected to be the main mode of transmission.[23] It can spread from an infected person for up to two days before they display symptoms, and from people who are asymptomatic.[20] People remain infectious for seven to twelve days in moderate cases, and up to two weeks in severe cases.[20][12] The standard method of diagnosis is by real-time reverse transcription polymerase chain reaction (rRT-PCR) from a nasopharyngeal swab.

Recommended measures to prevent infection include frequent social distancing, quarantine, covering coughs and sneezes, hand washing, and keeping unwashed hands away from the face.[7] The use of face masks or cloth face coverings has been recommended by health officials in public settings to minimise the risk of transmissions, with some authorities requiring their use in certain settings, such as on public transport and in shops.

There are no proven vaccines or specific treatments for COVID-19 yet, though several are in development. Management involves the treatment of symptoms, supportive care, isolation, and experimental measures. The World Health Organization (WHO) declared the COVID-19 outbreak a pandemic on 11 March 2020.[24]

Symptoms of COVID-19 can be relatively non-specific; the two most common symptoms are fever (88 percent) and dry cough (68 percent).[28][29] Among those who develop symptoms, approximately one in five may become more seriously ill and have difficulty breathing. Emergency symptoms include difficulty breathing, persistent chest pain or pressure, sudden confusion, difficulty waking, and bluish face or lips; immediate medical attention is advised if these symptoms are present.[29] Further development of the disease can lead to complications including pneumonia, acute respiratory distress syndrome, sepsis, septic shock, and kidney failure.

COVID-19 is caused by infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus strain.

COVID-19 is thought to spread mainly through the respiratory route (both droplet and aerosol), after an infected person coughs, sneezes, sings, talks or breathes.[32] A new infection occurs when those droplets get into the mouth, nose or eyes of other people who are in close contact[b] with the infected person.[33][34][35] The respiratory droplets evaporate into aerosols, which remain suspended in the air for longer periods of time,[36][37][38] causing airborne transmission particularly in crowded and inadequately ventilated indoor spaces, such as restaurants, nightclubs or choirs.[36][34][39][38] It also can occur in the healthcare setting, with certain aerosol-generating medical procedures performed on COVID-19 patients.[36][39]

It may be possible that a person can get COVID-19 through indirect contact by touching a contaminated surface or object, and then touching their own mouth, nose, or possibly their eyes,[39] though this is not thought to be the main way the virus spreads.[34] Kissing, physical intimacy and other forms of direct contact can easily transmit the virus and thus lead to COVID-19 in people exposed to such contact. There currently is no significant evidence of COVID-19 virus transmission through feces, urine, breast milk, food, wastewater, drinking water, animal disease vectors, or from mother to baby during pregnancy, although research is ongoing and caution is advised.[39][40][needs update]

Social distancing and the wearing of cloth face masks, surgical masks, respirators, or other face coverings are controls for droplet transmission. Transmission may be decreased indoors with well maintained heating and ventilation systems to maintain good air circulation and increase the use of outdoor air.[34]

The number of people generally infected by one infected person varies;[41] as of September 2020 it was estimated that one infected person will on average infect between two and three other people.[42] This is more infectious than influenza, but less so than measles.[43] It often spreads in clusters, where infections can be traced back to an index case or geographical location.[44] There is a major role of "super-spreading events", where many people are infected by one person.[41]

Severe acute respiratory syndrome coronavirus2 (SARS-CoV-2) is a novel severe acute respiratory syndrome coronavirus. It was first isolated from three people with pneumonia connected to the cluster of acute respiratory illness cases in Wuhan.[47] All features of the novel SARS-CoV-2 virus occur in related coronaviruses in nature.[48]

Outside the human body, the virus is destroyed by household soap, which bursts its protective bubble.[49]

SARS-CoV-2 is closely related to the original SARS-CoV.[50] It is thought to have an animal (zoonotic) origin. Genetic analysis has revealed that the coronavirus genetically clusters with the genus Betacoronavirus, in subgenus Sarbecovirus (lineage B) together with two bat-derived strains. It is 96% identical at the whole genome level to other bat coronavirus samples (BatCov RaTG13).[51][52]

COVID-19 can affect the upper respiratory tract (sinuses, nose, and throat) and the lower respiratory tract (windpipe and lungs).[53] The lungs are the organs most affected by COVID-19 because the virus accesses host cells via the enzyme angiotensin-converting enzyme 2 (ACE2), which is most abundant in type II alveolar cells of the lungs.[54] The virus uses a special surface glycoprotein called a "spike" (peplomer) to connect to ACE2 and enter the host cell.[55] The density of ACE2 in each tissue correlates with the severity of the disease in that tissue and some have suggested decreasing ACE2 activity might be protective,[56] though another view is that increasing ACE2 using angiotensin II receptor blocker medications could be protective.[57] As the alveolar disease progresses, respiratory failure might develop and death may follow.[58]

SARS-CoV-2 may also cause respiratory failure through affecting the brain stem as other coronaviruses have been found to invade the Central nervous system (CNS). While virus has been detected in cerebrospinal fluid of autopsies, the exact mechanism by which it invades the CNS remains unclear and may first involve invasion of peripheral nerves given the low levels of ACE2 in the brain.[59][60][61]

The virus also affects gastrointestinal organs as ACE2 is abundantly expressed in the glandular cells of gastric, duodenal and rectal epithelium[62] as well as endothelial cells and enterocytes of the small intestine.[63]

The virus can cause acute myocardial injury and chronic damage to the cardiovascular system.[64] An acute cardiac injury was found in 12% of infected people admitted to the hospital in Wuhan, China,[65] and is more frequent in severe disease.[66] Rates of cardiovascular symptoms are high, owing to the systemic inflammatory response and immune system disorders during disease progression, but acute myocardial injuries may also be related to ACE2 receptors in the heart.[64] ACE2 receptors are highly expressed in the heart and are involved in heart function.[64][67] A high incidence of thrombosis and venous thromboembolism have been found in ICU patients with COVID-19 infections, and may be related to poor prognosis.[68] Blood vessel dysfunction and clot formation (as suggested by high D-dimer levels) are thought to play a significant role in mortality, incidences of clots leading to pulmonary embolisms, and ischaemic events within the brain have been noted as complications leading to death in patients infected with SARS-CoV-2. Infection appears to set off a chain of vasoconstrictive responses within the body, constriction of blood vessels within the pulmonary circulation has also been posited as a mechanism in which oxygenation decreases alongside the presentation of viral pneumonia.[69]

Another common cause of death is complications related to the kidneys.[69] Early reports show that up to 30% of hospitalized patients both in China and in New York have experienced some injury to their kidneys, including some persons with no previous kidney problems.[70]

Autopsies of people who died of COVID-19 have found diffuse alveolar damage (DAD), and lymphocyte-containing inflammatory infiltrates within the lung.[71]

Although SARS-CoV-2 has a tropism for ACE2-expressing epithelial cells of the respiratory tract, patients with severe COVID-19 have symptoms of systemic hyperinflammation. Clinical laboratory findings of elevated IL-2, IL-7, IL-6, granulocyte-macrophage colony-stimulating factor (GM-CSF), interferon- inducible protein 10 (IP-10), monocyte chemoattractant protein1 (MCP-1), Macrophage inflammatory protein 1- (MIP-1), and tumour necrosis factor- (TNF-) indicative of cytokine release syndrome (CRS) suggest an underlying immunopathology.[65]

Additionally, people with COVID-19 and acute respiratory distress syndrome (ARDS) have classical serum biomarkers of CRS, including elevated C-reactive protein (CRP), lactate dehydrogenase (LDH), D-dimer, and ferritin.[72]

Systemic inflammation results in vasodilation, allowing inflammatory lymphocytic and monocytic infiltration of the lung and the heart. In particular, pathogenic GM-CSF-secreting T-cells were shown to correlate with the recruitment of inflammatory IL-6-secreting monocytes and severe lung pathology in COVID-19 patients.[73] Lymphocytic infiltrates have also been reported at autopsy.[71]

The WHO has published several testing protocols for the disease.[75] The standard method of testing is real-time reverse transcription polymerase chain reaction (rRT-PCR).[76] The test is typically done on respiratory samples obtained by a nasopharyngeal swab; however, a nasal swab or sputum sample may also be used.[77][78] Results are generally available within a few hours to two days.[79][80] Blood tests can be used, but these require two blood samples taken two weeks apart, and the results have little immediate value.[81] Chinese scientists were able to isolate a strain of the coronavirus and publish the genetic sequence so laboratories across the world could independently develop polymerase chain reaction (PCR) tests to detect infection by the virus.[82][83][84] As of 4April2020[update], antibody tests (which may detect active infections and whether a person had been infected in the past) were in development, but not yet widely used.[85][86][87] Antibody tests may be most accurate 23 weeks after a person's symptoms start.[88] The Chinese experience with testing has shown the accuracy is only 60 to 70%.[89] The US Food and Drug Administration (FDA) approved the first point-of-care test on 21 March 2020 for use at the end of that month.[90] The absence or presence of COVID-19 signs and symptoms alone is not reliable enough for an accurate diagnosis.[91] Different clinical scores were created based on symptoms, laboratory parameters and imaging to determine patients with probable SARS-CoV-2 infection or more severe stages of COVID-19.[92][93]

Diagnostic guidelines released by Zhongnan Hospital of Wuhan University suggested methods for detecting infections based upon clinical features and epidemiological risk. These involved identifying people who had at least two of the following symptoms in addition to a history of travel to Wuhan or contact with other infected people: fever, imaging features of pneumonia, normal or reduced white blood cell count, or reduced lymphocyte count.[94]

A study asked hospitalised COVID-19 patients to cough into a sterile container, thus producing a saliva sample, and detected the virus in eleven of twelve patients using RT-PCR. This technique has the potential of being quicker than a swab and involving less risk to health care workers (collection at home or in the car).[95]

Along with laboratory testing, chest CT scans may be helpful to diagnose COVID-19 in individuals with a high clinical suspicion of infection but are not recommended for routine screening.[96][97] Bilateral multilobar ground-glass opacities with a peripheral, asymmetric, and posterior distribution are common in early infection.[96][98] Subpleural dominance, crazy paving (lobular septal thickening with variable alveolar filling), and consolidation may appear as the disease progresses.[96][99]

In late 2019, the WHO assigned emergency ICD-10 disease codes U07.1 for deaths from lab-confirmed SARS-CoV-2 infection and U07.2 for deaths from clinically or epidemiologically diagnosed COVID-19 without lab-confirmed SARS-CoV-2 infection.[100]

CT scan of rapid progression stage of COVID-19.

Chest X-ray showing COVID-19 pneumonia.

The main pathological findings at autopsy are:[71]

A COVID-19 vaccine is not expected until 2021 at the earliest.[110] The US National Institutes of Health guidelines do not recommend any medication for prevention of COVID-19, before or after exposure to the SARS-CoV-2 virus, outside the setting of a clinical trial.[111][112] Without a vaccine, other prophylactic measures, or effective treatments, a key part of managing COVID-19 is trying to decrease and delay the epidemic peak, known as "flattening the curve".[106] This is done by slowing the infection rate to decrease the risk of health services being overwhelmed, allowing for better treatment of current cases, and delaying additional cases until effective treatments or a vaccine become available.[106][109]

Preventive measures to reduce the chances of infection include staying at home, wearing a mask in public, avoiding crowded places, keeping distance from others, washing hands with soap and water often and for at least 20 seconds, practising good respiratory hygiene, and avoiding touching the eyes, nose, or mouth with unwashed hands.[113][114][115][116] Those diagnosed with COVID-19 or who believe they may be infected are advised by the CDC to stay home except to get medical care, call ahead before visiting a healthcare provider, wear a face mask before entering the healthcare provider's office and when in any room or vehicle with another person, cover coughs and sneezes with a tissue, regularly wash hands with soap and water and avoid sharing personal household items.[117][118]

For health care professionals who may come into contact with COVID-19 positive bodily fluids, using personal protective coverings on exposed body parts improves protection from the virus.[119] Breathable personal protective equipment[clarification needed] improves user-satisfaction and may offer a similar level of protection from the virus.[119] In addition, adding tabs and other modifications to the protective equipment may reduce the risk of contamination during donning and doffing (putting on and taking off the equipment).[119] Implementing an evidence-based donning and doffing protocol such as a one-step glove and gown removal technique, giving oral instructions while donning and doffing, double gloving, and the use of glove disinfection may also improve protection for health care professionals.[119]

The World Health Organization (WHO) and most government health agencies (such as the US Centers for Disease Control and Prevention (CDC), the UK National Health Service (NHS), or the New Zealand Ministry of Health) recommend individuals wear non-medical face coverings in public settings where there is an increased risk of transmission and where social distancing measures are difficult to maintain.[120][121][122][123][124] This recommendation is meant to reduce the spread of the disease by asymptomatic and pre-symptomatic individuals and is complementary to established preventive measures such as social distancing.[121][125] Face coverings limit the volume and travel distance of expiratory droplets dispersed when talking, breathing, and coughing.[121][125] Many countries and local jurisdictions encourage or mandate the use of face masks or cloth face coverings by members of the public to limit the spread of the virus.[126][127][128][129]

Masks are also strongly recommended for those who may have been infected and those taking care of someone who may have the disease.[130]

Social distancing strategies aim to reduce contact of infected persons with large groups by closing schools and workplaces, restricting travel, and cancelling large public gatherings.[131] Distancing guidelines also include that people stay at least 2 metres (6.6ft) apart.[132] After the implementation of social distancing and stay-at-home orders, many regions have been able to sustain an effective transmission rate ("Rt") of less than one, meaning the disease is in remission in those areas.[133]

When not wearing a mask, the CDC, WHO, and NHS recommends covering the mouth and nose with a tissue when coughing or sneezing and recommends using the inside of the elbow if no tissue is available.[114][123][134] Proper hand hygiene after any cough or sneeze is encouraged.[114][123] The WHO also recommends that individuals wash hands often with soap and water for at least 20 seconds, especially after going to the toilet or when hands are visibly dirty, before eating and after blowing one's nose.[134] The CDC recommends using an alcohol-based hand sanitiser with at least 60% alcohol, but only when soap and water are not readily available.[123] For areas where commercial hand sanitisers are not readily available, the WHO provides two formulations for local production. In these formulations, the antimicrobial activity arises from ethanol or isopropanol. Hydrogen peroxide is used to help eliminate bacterial spores in the alcohol; it is "not an active substance for hand antisepsis". Glycerol is added as a humectant.[135]

Sanitizing of frequently touched surfaces is also recommended or required by regulation for businesses and public facilities; the United States Environmental Protection Agency maintains a list of products expected to be effective.[136]

People are managed with supportive care, which may include fluid therapy, oxygen support, and supporting other affected vital organs.[137][138][139] The CDC recommends those who suspect they carry the virus wear a simple face mask.[117] Extracorporeal membrane oxygenation (ECMO) has been used to address the issue of respiratory failure, but its benefits are still under consideration.[140][needs update] Personal hygiene and a healthy lifestyle and diet have been recommended to improve immunity.[141] Supportive treatments may be useful in those with mild symptoms at the early stage of infection.[142]

The WHO, the Chinese National Health Commission, and the United States' National Institutes of Health have published recommendations for taking care of people who are hospitalised with COVID-19.[111][143][144] Intensivists and pulmonologists in the US have compiled treatment recommendations from various agencies into a free resource, the IBCC.[145][146]

The severity of COVID-19 varies. The disease may take a mild course with few or no symptoms, resembling other common upper respiratory diseases such as the common cold. Mild cases typically recover within two weeks, while those with severe or critical diseases may take three to six weeks to recover. Among those who have died, the time from symptom onset to death has ranged from two to eight weeks.[51] The Italian Istituto Superiore di Sanit reported that the median time between the onset of symptoms and death was twelve days, with seven being spent hospitalised. However, people transferred to an ICU had a median time of ten days between hospitalisation and death.[153]

According to scientific reviews smokers are more likely to require intensive care or die compared to non-smokers,[154][155] air pollution is similarly associated with risk factors,[155] and pre-existing heart and lung diseases[156] and also obesity contributes to an increased health risk of COVID-19.[155][157][158]

It is also assumed that those that are immunocompromised are at higher risk of getting severely sick from SARS-CoV-2.[159] One research that looked into the COVID-19 infections in hospitalized kidney transplant recipients found a mortality rate of 11%.[160]

Children make up a small proportion of reported cases, with about 1% of cases being under 10 years and 4% aged 1019 years.[12] They are likely to have milder symptoms and a lower chance of severe disease than adults.

A European multinational study of hospitalized children published in The Lancet on 25 June 2020 found that about 8% of children admitted to a hospital needed intensive care. Four of those 582 children (0.7%) died, but the actual mortality rate could be "substantially lower" since milder cases that did not seek medical help were not included in the study.[161]

Mortality rates are highly correlated to age. In those younger than 50 years the risk of death is less than 0.5%, while in those older than 70 it is more than 8%.[162][163][164] According to a CDC analysis, the risk of death by age groups in the United States is 0.003%, 0.02%; 0.5% and 5.4% for the age groups 019, 2049, 5069, and 70 or over, respectively.[165][166]

Genetics also plays an important role in the ability to fight off the disease. For instance, those that do not produce detectable type I-interferons may get much sicker from COVID-19.[167][168] Genetic screening is able to detect interferon effector genes.[169]

Pregnant women may be at higher risk of severe COVID-19 infection based on data from other similar viruses, like severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), but data for COVID-19 is lacking.[170][171]

Most of those who die of COVID-19 have pre-existing (underlying) conditions, including hypertension, diabetes mellitus, and cardiovascular disease.[218] According to March data from the United States, 89% of those hospitalised had preexisting conditions.[219] The Italian Istituto Superiore di Sanit reported that out of 8.8% of deaths where medical charts were available, 96.1% of people had at least one comorbidity with the average person having 3.4 diseases.[153] According to this report the most common comorbidities are hypertension (66% of deaths), type 2 diabetes (29.8% of deaths), ischemic heart disease (27.6% of deaths), atrial fibrillation (23.1% of deaths) and chronic renal failure (20.2% of deaths).

Most critical respiratory comorbidities according to the CDC, are: moderate or severe asthma, pre-existing COPD, pulmonary fibrosis, cystic fibrosis.[220] Evidence stemming from meta-analysis of several smaller research papers also suggests that smoking can be associated with worse patient outcomes.[221][222] When someone with existing respiratory problems is infected with COVID-19, they might be at greater risk for severe symptoms.[223] COVID-19 also poses a greater risk to people who misuse opioids and methamphetamines, insofar as their drug use may have caused lung damage.[224]

Complications may include pneumonia, acute respiratory distress syndrome (ARDS), multi-organ failure, septic shock, and death.[82][225][226][227][228]

Cardiovascular complications may include heart failure, arrhythmias, heart inflammation, and blood clots.[229][230][231][232]

Approximately 2030% of people who present with COVID-19 have elevated liver enzymes reflecting liver injury.[233][112]

Neurologic manifestations include seizure, stroke, encephalitis, and GuillainBarr syndrome (which includes loss of motor functions).[234][235] Following the infection, children may develop paediatric multisystem inflammatory syndrome, which has symptoms similar to Kawasaki disease, which can be fatal.[236][237]

Some early studies [238][239] suggest between 1 in 5 and 1 in 10 people with COVID-19 will experience symptoms lasting longer than a month. A majority of those who were admitted to hospital with severe disease report long-term problems including fatigue and shortness of breath.[240]

The immune response by humans to CoV-2 virus occurs as a combination of the cell-mediated immunity and antibody production,[241] just as with most other infections.[242] However, it remains unknown if the immunity is long-lasting in people who recover from the disease.[needs update][243] Cases in which recovery from COVID-19 was followed by positive tests for coronavirus at a later date have been reported. In some of these cases, the RNA from the first and second infections indicates a different strain of the virus.[244][245][246][247] Some reinfection cases are believed to be lingering infection rather than reinfection,[247] or false positives due to remaining, non-infectious RNA fragments.[248] Some other coronaviruses circulating in people are capable of reinfection after roughly a year.[249]

The virus is thought to be natural and has an animal origin,[48] through spillover infection.[250] The first known human infections were in Wuhan, Hubei, China. A study of the first 41 cases of confirmed COVID-19, published in January 2020 in The Lancet, reported the earliest date of onset of symptoms as 1December 2019.[251][252][253] Official publications from the WHO reported the earliest onset of symptoms as 8December 2019.[254] Human-to-human transmission was confirmed by the WHO and Chinese authorities by 20 January 2020.[255][256] According to official Chinese sources, these were mostly linked to the Huanan Seafood Wholesale Market, which also sold live animals.[257] In May 2020, George Gao, the director of the Chinese Center for Disease Control and Prevention, said animal samples collected from the seafood market had tested negative for the virus, indicating that the market was the site of an early superspreading event, but it was not the site of the initial outbreak.[258] Traces of the virus have been found in wastewater that was collected from Milan and Turin, Italy, on 18 December 2019.[259]

There are several theories about where the first case (the so-called patient zero) originated.[260] According to an unpublicised report from the Chinese government, the first case can be traced back to 17 November 2019; the person was a 55-year-old citizen in the Hubei province. There were four men and five women reported to be infected in November, but none of them were "patient zero". By December 2019, the spread of infection was almost entirely driven by human-to-human transmission.[148][261] The number of coronavirus cases in Hubei gradually increased, reaching 60 by 20 December[262] and at least 266 by 31 December.[263] On 24 December, Wuhan Central Hospital sent a bronchoalveolar lavage fluid (BAL) sample from an unresolved clinical case to sequencing company Vision Medicals. On 27 and 28 December, Vision Medicals informed the Wuhan Central Hospital and the Chinese CDC of the results of the test, showing a new coronavirus.[264] A pneumonia cluster of unknown cause was observed on 26 December and treated by the doctor Zhang Jixian in Hubei Provincial Hospital, who informed the Wuhan Jianghan CDC on 27 December.[265] On 30 December, a test report addressed to Wuhan Central Hospital, from company CapitalBio Medlab, stated an erroneous positive result for SARS, causing a group of doctors at Wuhan Central Hospital to alert their colleagues and relevant hospital authorities of the result. That evening, the Wuhan Municipal Health Commission issued a notice to various medical institutions on "the treatment of pneumonia of unknown cause".[266] Eight of these doctors, including Li Wenliang (punished on 3January),[267] were later admonished by the police for spreading false rumours, and another, Ai Fen, was reprimanded by her superiors for raising the alarm.[268]

The Wuhan Municipal Health Commission made the first public announcement of a pneumonia outbreak of unknown cause on 31 December, confirming 27 cases[269][270][271]enough to trigger an investigation.[272]

During the early stages of the outbreak, the number of cases doubled approximately every seven and a half days.[273] In early and mid-January 2020, the virus spread to other Chinese provinces, helped by the Chinese New Year migration and Wuhan being a transport hub and major rail interchange.[51] On 20 January, China reported nearly 140 new cases in one day, including two people in Beijing and one in Shenzhen.[274] Later official data shows 6,174 people had already developed symptoms by then,[275] and more may have been infected.[276] A report in The Lancet on 24 January indicated human transmission, strongly recommended personal protective equipment for health workers, and said testing for the virus was essential due to its "pandemic potential".[65][277] On 30 January, the WHO declared the coronavirus a Public Health Emergency of International Concern.[276] By this time, the outbreak spread by a factor of 100 to 200 times.[278]

On 31 January 2020, Italy had its first confirmed cases, two tourists from China.[279] As of 13 March 2020, the World Health Organization (WHO) considered Europe the active centre of the pandemic.[280] On 19 March 2020, Italy overtook China as the country with the most deaths.[281] By 26 March, the United States had overtaken China and Italy with the highest number of confirmed cases in the world.[282] Research on coronavirus genomes indicates the majority of COVID-19 cases in New York came from European travellers, rather than directly from China or any other Asian country.[283] Retesting of prior samples found a person in France who had the virus on 27 December 2019[284][285] and a person in the United States who died from the disease on 6February 2020.[286]

On 11 June 2020, after 55 days without a locally transmitted case,[287] Beijing reported the first COVID-19 case, followed by two more cases on 12 June.[288] By 15 June 79 cases were officially confirmed.[289] Most of these patients went to Xinfadi Wholesale Market.[287][290]

Several measures are commonly used to quantify mortality.[291] These numbers vary by region and over time and are influenced by the volume of testing, healthcare system quality, treatment options, time since the initial outbreak, and population characteristics such as age, sex, and overall health.[292]

The death-to-case ratio reflects the number of deaths divided by the number of diagnosed cases within a given time interval. Based on Johns Hopkins University statistics, the global death-to-case ratio is 2.8% (1,117,252/40,327,407) as of 20 October 2020.[8] The number varies by region.[293]

Other measures include the case fatality rate (CFR), which reflects the percentage of diagnosed individuals who die from a disease, and the infection fatality rate (IFR), which reflects the percentage of infected individuals (diagnosed and undiagnosed) who die from a disease. These statistics are not time-bound and follow a specific population from infection through case resolution. Many academics have attempted to calculate these numbers for specific populations.[294]

Outbreaks have occurred in prisons due to crowding and an inability to enforce adequate social distancing.[295][296] In the United States, the prisoner population is aging and many of them are at high risk for poor outcomes from COVID-19 due to high rates of coexisting heart and lung disease, and poor access to high-quality healthcare.[295]

Total confirmed cases over time

Infection fatality rate or infection fatality ratio (IFR) is distinguished from case fatality rate (CFR). The CFR for a disease is the proportion of deaths from the disease compared to the total number of people diagnosed with the disease (within a certain period of time). The IFR, in contrast, is the proportion of deaths among all the infected individuals. IFR, unlike CFR, attempts to account for all asymptomatic and undiagnosed infections.

In February, the World Health Organization reported estimates of IFR between 0.3% and 1%.[299][300] On 2July, The WHO's Chief Scientist reported that the average IFR estimate presented at a two-day WHO expert forum was about 0.6%.[301][302]

The CDC estimated for planning purposes that the IFR was 0.65% and that 40% of infected individuals are asymptomatic, suggesting a fatality rate among those who are symptomatic of 1.1% (.65/60) (as of 10 July).[303][304] Studies incorporating data from broad serology testing in Europe show IFR estimates converging at approximately 0.51%.[305] According to the University of Oxford Centre for Evidence-Based Medicine (CEBM), random antibody testing in Germany suggested a national IFR of 0.4% (0.1% to 0.9%).[306][307][308]

Firm lower limits of IFRs have been established in a number of locations such as New York City and Bergamo in Italy since the IFR cannot be less than the population fatality rate. As of 10July, in New York City, with a population of 8.4million, 23,377 individuals (18,758 confirmed and 4,619 probable) have died with COVID-19 (0.3% of the population).[309] May antibody testing in New York City suggested an IFR of 0.9%.[310] In Bergamo province, 0.6% of the population has died.[311]

Early reviews of epidemiologic data showed greater impact of the pandemic and a higher mortality rate in men in China and Italy.[312][1][313] The Chinese Center for Disease Control and Prevention reported the death rate was 2.8% for men and 1.7% for women.[314] Later reviews in June 2020 indicated that there is no significant difference in susceptibility or in CFR between genders.[315][316] One review acknowledges the different mortality rates in Chinese men, suggesting that it may be attributable to lifestyle choices such as smoking and drinking alcohol rather than genetic factors.[317] Sex-based immunological differences, lesser prevalence of smoking in women and men developing co-morbid conditions such as hypertension at a younger age than women could have contributed to the higher mortality in men.[318] In Europe, 57% of the infected people were men and 72% of those died with COVID-19 were men.[319] As of April 2020, the US government is not tracking sex-related data of COVID-19 infections.[320] Research has shown that viral illnesses like Ebola, HIV, influenza and SARS affect men and women differently.[320]

In the US, a greater proportion of deaths due to COVID-19 have occurred among African Americans.[322] Structural factors that prevent African Americans from practicing social distancing include their concentration in crowded substandard housing and in "essential" occupations such as public transit and health care. Greater prevalence of lacking health insurance and care and of underlying conditions such as diabetes, hypertension and heart disease also increase their risk of death.[323] Similar issues affect Native American and Latino communities.[322] According to a US health policy non-profit, 34% of American Indian and Alaska Native People (AIAN) non-elderly adults are at risk of serious illness compared to 21% of white non-elderly adults.[324] The source attributes it to disproportionately high rates of many health conditions that may put them at higher risk as well as living conditions like lack of access to clean water.[325] Leaders have called for efforts to research and address the disparities.[326]

In the U.K., a greater proportion of deaths due to COVID-19 have occurred in those of a Black, Asian, and other ethnic minority background.[327][328][329]

During the initial outbreak in Wuhan, China, the virus and disease were commonly referred to as "coronavirus" and "Wuhan coronavirus",[330][331][332] with the disease sometimes called "Wuhan pneumonia".[333][334] In the past, many diseases have been named after geographical locations, such as the Spanish flu,[335] Middle East Respiratory Syndrome, and Zika virus.[336]

In January 2020, the World Health Organization recommended 2019-nCov[337] and 2019-nCoV acute respiratory disease[338] as interim names for the virus and disease per 2015 guidance and international guidelines against using geographical locations (e.g. Wuhan, China), animal species, or groups of people in disease and virus names in part to prevent social stigma.[339][340][341]

The official names COVID-19 and SARS-CoV-2 were issued by the WHO on 11 February 2020.[342] WHO chief Tedros Adhanom Ghebreyesus explained: CO for corona, VI for virus, Dfor disease and 19 for when the outbreak was first identified (31 December 2019).[343] The WHO additionally uses "the COVID-19 virus" and "the virus responsible for COVID-19" in public communications.[342]

After the initial outbreak of COVID-19, misinformation and disinformation regarding the origin, scale, prevention, treatment, and other aspects of the disease rapidly spread online.[344][345][346]

Humans appear to be capable of spreading the virus to some other animals. A domestic cat in Lige, Belgium, tested positive after it started showing symptoms (diarrhoea, vomiting, shortness of breath) a week later than its owner, who was also positive.[347] Tigers and lions at the Bronx Zoo in New York, United States, tested positive for the virus and showed symptoms of COVID-19, including a dry cough and loss of appetite.[348] Minks at two farms in the Netherlands also tested positive for COVID-19.[349]

A study on domesticated animals inoculated with the virus found that cats and ferrets appear to be "highly susceptible" to the disease, while dogs appear to be less susceptible, with lower levels of viral replication. The study failed to find evidence of viral replication in pigs, ducks, and chickens.[350]

In March 2020, researchers from the University of Hong Kong have shown that Syrian hamsters could be a model organism for COVID-19 research.[351]

As of August 2020, dozens of domestic cats and dogs had tested positive, though according to the U.S. CDC, there was no evidence they transmitted the virus to humans.[352] CDC guidance recommends potentially infected people avoid close contact with pets.[352]

No medication or vaccine other than remdesivir is approved with the specific indication to treat the disease.[353] In Australia and the European Union, remdesivir (Veklury) is indicated for the treatment of COVID-19 in adults and adolescents (aged 12 years and older with body weight at least 40kg) with pneumonia requiring supplemental oxygen.[354][355][356] International research on vaccines and medicines in COVID-19 is underway by government organisations, academic groups, and industry researchers.[357][358] In March, the World Health Organization initiated the "Solidarity Trial" to assess the treatment effects of four existing antiviral compounds with the most promise of efficacy.[359] The World Health Organization suspended hydroxychloroquine from its global drug trials for COVID-19 treatments on 26 May 2020 due to safety concerns. It had previously enrolled 3,500 patients from 17 countries in the Solidarity Trial.[360] France, Italy and Belgium also banned the use of hydroxychloroquine as a COVID-19 treatment.[361]

Modelling research has been conducted with several objectives, including predictions of the dynamics of transmission,[362] diagnosis and prognosis of infection,[363] estimation of the impact of interventions,[364][365] or allocation of resources.[366] Modelling studies are mostly based on epidemiological models,[367] estimating the number of infected people over time under given conditions. Several other types of models have been developed and used during the COVID-19 including computational fluid dynamics models to study the flow physics of COVID-19,[368] retrofits of crowd movement models to study occupant exposure,[369] mobility-data based models to investigate transmission,[370] or the use of macroeconomic models to assess the economic impact of the pandemic.[371]

There has been a great deal of COVID-19 research, involving accelerated research processes and publishing shortcuts to meet the global demand. To minimise the harm from misinformation, medical professionals and the public are advised to expect rapid changes to available information, and to be attentive to retractions and other updates.[372]

At least 29 Phase IIIV efficacy trials in COVID-19 were concluded in March 2020, or scheduled to provide results in April from hospitals in China.[380][381] There are more than 300 active clinical trials underway as of April 2020.[112] Seven trials were evaluating already approved treatments, including four studies on hydroxychloroquine or chloroquine.[381] Repurposed antiviral drugs make up most of the research, with nine PhaseIII trials on remdesivir across several countries due to report by the end of April.[380][381] Other candidates in trials include vasodilators, corticosteroids, immune therapies, lipoic acid, bevacizumab, and recombinant angiotensin-converting enzyme 2.[381]

The COVID-19 Clinical Research Coalition has goals to 1) facilitate rapid reviews of clinical trial proposals by ethics committees and national regulatory agencies, 2) fast-track approvals for the candidate therapeutic compounds, 3) ensure standardised and rapid analysis of emerging efficacy and safety data and 4) facilitate sharing of clinical trial outcomes before publication.[382][383]

Several existing medications are being evaluated for the treatment of COVID-19,[353] including remdesivir, chloroquine, hydroxychloroquine, lopinavir/ritonavir, and lopinavir/ritonavir combined with interferon beta.[359][384] There is tentative evidence for efficacy by remdesivir, and on 1May 2020, the United States Food and Drug Administration (FDA) gave the drug an emergency use authorization (EUA) for people hospitalized with severe COVID-19.[385] On 28 August 2020, the FDA broadened the EUA for remdesivir to include all hospitalized patients with suspected or laboratory-confirmed COVID-19, irrespective of the severity of their disease.[386][387][388] Phase III clinical trials for several drugs[which?] are underway[when?] in several countries, including the US, China, and Italy.[353][380][389]

There are mixed results as of 3 April 2020, as to the effectiveness of hydroxychloroquine as a treatment for COVID-19, with some studies showing little or no improvement.[390][391] One study has shown an association between hydroxychloroquine or chloroquine use with higher death rates along with other side effects.[392][393] A retraction of this study by its authors was published by The Lancet on 4June 2020.[394] The studies of chloroquine and hydroxychloroquine with or without azithromycin have major limitations that have prevented the medical community from embracing these therapies without further study.[112] On 15 June 2020, the FDA updated the fact sheets for the emergency use authorization of remdesivir to warn that using chloroquine or hydroxychloroquine with remdesivir may reduce the antiviral activity of remdesivir.[395]

In June, initial results from a randomised trial in the United Kingdom showed that dexamethasone reduced mortality by one third for patients who are critically ill on ventilators and one fifth for those receiving supplemental oxygen.[396] Because this is a well tested and widely available treatment this was welcomed by the WHO that is in the process of updating treatment guidelines to include dexamethasone or other steroids.[397][398] Based on those preliminary results, dexamethasone treatment has been recommended by the National Institutes of Health for patients with COVID-19 who are mechanically ventilated or who require supplemental oxygen but not in patients with COVID-19 who do not require supplemental oxygen.[399]

In September 2020, the WHO released updated guidance on using corticosteroids for COVID-19.[400] The WHO recommends systemic corticosteroids rather than no systemic corticosteroids for the treatment of people with severe and critical COVID-19 (strong recommendation, based on moderate certainty evidence).[400] The WHO suggests not to use corticosteroids in the treatment of people with non-severe COVID-19 (conditional recommendation, based on low certainty evidence).[400] The updated guidance was based on a meta-analysis of clinical trials of critically ill COVID-19 patients.[401][402]

In September 2020, the European Medicines Agency (EMA) endorsed the use of dexamethasone in adults and adolescents (from twelve years of age and weighing at least 40kg) who require supplemental oxygen therapy.[403] Dexamethasone can be taken by mouth or given as an injection or infusion (drip) into a vein.[403]

A cytokine storm can be a complication in the later stages of severe COVID-19. There is preliminary evidence that hydroxychloroquine may be useful in controlling cytokine storms in late-phase severe forms of the disease.[404]

Tocilizumab has been included in treatment guidelines by China's National Health Commission after a small study was completed.[405][406] It is undergoing a PhaseII non-randomised trial at the national level in Italy after showing positive results in people with severe disease.[407][408] Combined with a serum ferritin blood test to identify a cytokine storm (also called cytokine storm syndrome, not to be confused with cytokine release syndrome), it is meant to counter such developments, which are thought to be the cause of death in some affected people.[409][410][411] The interleukin-6 receptor antagonist was approved by the Food and Drug Administration (FDA) to undergo a PhaseIII clinical trial assessing its effectiveness on COVID-19 based on retrospective case studies for the treatment of steroid-refractory cytokine release syndrome induced by a different cause, CAR T cell therapy, in 2017.[412] To date,[when?] there is no randomised, controlled evidence that tocilizumab is an efficacious treatment for CRS. Prophylactic tocilizumab has been shown to increase serum IL-6 levels by saturating the IL-6R, driving IL-6 across the blood-brain barrier, and exacerbating neurotoxicity while having no effect on the incidence of CRS.[413]

Lenzilumab, an anti-GM-CSF monoclonal antibody, is protective in murine models for CAR T cell-induced CRS and neurotoxicity and is a viable therapeutic option due to the observed increase of pathogenic GM-CSF secreting T-cells in hospitalised patients with COVID-19.[414]

The Feinstein Institute of Northwell Health announced in March a study on "a human antibody that may prevent the activity" of IL-6.[415]

Transferring purified and concentrated antibodies produced by the immune systems of those who have recovered from COVID-19 to people who need them is being investigated as a non-vaccine method of passive immunisation.[416][417] The safety and effectiveness of convalescent plasma as a treatment option requires further research.[417] This strategy was tried for SARS with inconclusive results.[416] Viral neutralization is the anticipated mechanism of action by which passive antibody therapy can mediate defence against SARS-CoV-2. The spike protein of SARS-CoV-2 is the primary target for neutralizing antibodies.[418] As of 8 August 2020, eight neutralizing antibodies targeting the spike protein of SARS-CoV-2 have entered clinical studies.[419] It has been proposed that selection of broad-neutralizing antibodies against SARS-CoV-2 and SARS-CoV might be useful for treating not only COVID-19 but also future SARS-related CoV infections.[418] Other mechanisms, however, such as antibody-dependent cellular cytotoxicity and/or phagocytosis, may be possible.[416] Other forms of passive antibody therapy, for example, using manufactured monoclonal antibodies, are in development.[416] Production of convalescent serum, which consists of the liquid portion of the blood from recovered patients and contains antibodies specific to this virus, could be increased for quicker deployment.[420]

Peru announced in April 2020 that it would begin working towards creating a vaccine, with the pharmaceutical company Farvet and Universidad Peruana Cayetano Heredia (UPCH) announcing plans to jointly develop a vaccine in Chincha.[421] Peru's Experimental Station for Scientific Research and Genetic Improvement of Alpacas belonging to the Inca Group, selected on 5 June 2020 four alpacas for the development of a new vaccine that it had been developing in conjunction with Farvet and UPCH. They also indicated that alpacas have the ability to generate some types of antibodies known as "nanobodies", which are very small and have a greater potential to treat pathogens.[422] According to Andina, research from the United States, Belgium, and Chile showed that antibodies from laminoid animals could possibly be formulated into inhaler or injection treatments for those infected with coronaviruses, with Teodosio Huanca of Peru's National Institute of Agricultural Innovation (INIA) National Camelid Program stating that Peruvian camelidae share the same genetic roots and antibodies.[423]

On 7 August, the Peruvian National Institute of Health (INS) announced that it would begin the development of a possible treatment for COVID-19 using "recombinant nanoantibodies" from a llama named "Tito".[424] According to the INIA, Peru holds "the only germplasm bank of South American camelids in the world, with 1,700 samples of alpacas and 1,200 of llamas".[424]

Originally posted here:

Coronavirus disease 2019 - Wikipedia

Covid-19: Dutch woman who caught virus twice dies – CNN

');$vidEndSlate.removeClass('video__end-slate--inactive').addClass('video__end-slate--active');}};CNN.autoPlayVideoExist = (CNN.autoPlayVideoExist === true) ? true : false;var configObj = {thumb: 'none',video: 'health/2020/08/24/first-documented-coronavirus-reinfection-case-hong-kong-pkg-tsr-vpx.cnn',width: '100%',height: '100%',section: 'domestic',profile: 'expansion',network: 'cnn',markupId: 'large-media_0',adsection: 'const-article-carousel-pagetop',frameWidth: '100%',frameHeight: '100%',posterImageOverride: {"mini":{"width":220,"type":"jpg","uri":"//cdn.cnn.com/cnnnext/dam/assets/200824190746-coronavirus-small-169.jpg","height":124},"xsmall":{"width":307,"type":"jpg","uri":"//cdn.cnn.com/cnnnext/dam/assets/200824190746-coronavirus-medium-plus-169.jpg","height":173},"small":{"width":460,"type":"jpg","uri":"//cdn.cnn.com/cnnnext/dam/assets/200824190746-coronavirus-large-169.jpg","height":259},"medium":{"width":780,"type":"jpg","uri":"//cdn.cnn.com/cnnnext/dam/assets/200824190746-coronavirus-exlarge-169.jpg","height":438},"large":{"width":1100,"type":"jpg","uri":"//cdn.cnn.com/cnnnext/dam/assets/200824190746-coronavirus-super-169.jpg","height":619},"full16x9":{"width":1600,"type":"jpg","uri":"//cdn.cnn.com/cnnnext/dam/assets/200824190746-coronavirus-full-169.jpg","height":900},"mini1x1":{"width":120,"type":"jpg","uri":"//cdn.cnn.com/cnnnext/dam/assets/200824190746-coronavirus-small-11.jpg","height":120}}},autoStartVideo = false,isVideoReplayClicked = false,callbackObj,containerEl,currentVideoCollection = [{"title":"Hong Kong researchers say man got Covid-19 twice","duration":"03:34","sourceName":"CNN","sourceLink":"https://cnn.com","videoCMSUrl":"/video/data/3.0/video/health/2020/08/24/first-documented-coronavirus-reinfection-case-hong-kong-pkg-tsr-vpx.cnn/index.xml","videoId":"health/2020/08/24/first-documented-coronavirus-reinfection-case-hong-kong-pkg-tsr-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/200824190746-coronavirus-large-169.jpg","videoUrl":"/videos/health/2020/08/24/first-documented-coronavirus-reinfection-case-hong-kong-pkg-tsr-vpx.cnn/video/playlists/coronavirus-intl/","description":"With the US death toll from coronavirus passing 177,000, researchers in China say a 33-year-old man living in in Hong Kong is the first person confirmed to have been reinfected with the virus. CNN's Brian Todd reports.","descriptionText":"With the US death toll from coronavirus passing 177,000, researchers in China say a 33-year-old man living in in Hong Kong is the first person confirmed to have been reinfected with the virus. CNN's Brian Todd reports."},{"title":"This area was already in isolation. Then came the Covid-19 lockdown","duration":"03:14","sourceName":"CNN","sourceLink":"https://www.cnn.com/","videoCMSUrl":"/video/data/3.0/video/world/2020/10/19/gaza-coronavirus-covid-19-blockaded-nat-sot-pkg-intl-hnk-vpx.cnn/index.xml","videoId":"world/2020/10/19/gaza-coronavirus-covid-19-blockaded-nat-sot-pkg-intl-hnk-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/201019094504-gaza-coronavirus-covid-19-blockaded-nat-sot-pkg-intl-hnk-vpx-00000000-large-169.jpg","videoUrl":"/videos/world/2020/10/19/gaza-coronavirus-covid-19-blockaded-nat-sot-pkg-intl-hnk-vpx.cnn/video/playlists/coronavirus-intl/","description":"The Gaza Strip is one of the most densely-populated areas in the world. After more than a decade under blockade, the Covid-19 lockdown is adding isolation and despair to the area. ","descriptionText":"The Gaza Strip is one of the most densely-populated areas in the world. After more than a decade under blockade, the Covid-19 lockdown is adding isolation and despair to the area. "},{"title":"Italy's second coronavirus wave feels different. Here's why","duration":"02:09","sourceName":"CNN","sourceLink":"https://www.cnn.com","videoCMSUrl":"/video/data/3.0/video/world/2020/10/19/italy-naples-coronavirus-covid-19-testing-wedeman-pkg-intl-ldn-vpx.cnn/index.xml","videoId":"world/2020/10/19/italy-naples-coronavirus-covid-19-testing-wedeman-pkg-intl-ldn-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/201019110927-italy-naples-coronavirus-covid-19-testing-wedeman-pkg-intl-ldn-vpx-00011514-large-169.jpg","videoUrl":"/videos/world/2020/10/19/italy-naples-coronavirus-covid-19-testing-wedeman-pkg-intl-ldn-vpx.cnn/video/playlists/coronavirus-intl/","description":"Italy recorded a record number of positive coronavirus tests for the fifth day running on October 18, but in a marked contrast to the 'first wave', the number of patients in intensive care remains relatively low. CNN's Ben Wedeman reports from Naples.","descriptionText":"Italy recorded a record number of positive coronavirus tests for the fifth day running on October 18, but in a marked contrast to the 'first wave', the number of patients in intensive care remains relatively low. CNN's Ben Wedeman reports from Naples."},{"title":"Tougher Covid-19 restrictions are once again the norm in Europe","duration":"01:58","sourceName":"CNN","sourceLink":"https://www.cnn.com","videoCMSUrl":"/video/data/3.0/video/world/2020/10/19/europe-england-france-poland-coronavirus-covid-19-second-wave-restrictions-mclean-pkg-intl-ldn-vpx.cnn/index.xml","videoId":"world/2020/10/19/europe-england-france-poland-coronavirus-covid-19-second-wave-restrictions-mclean-pkg-intl-ldn-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/201019102301-europe-covid-19-restrictions-mclean-pkg-10192020-large-169.jpg","videoUrl":"/videos/world/2020/10/19/europe-england-france-poland-coronavirus-covid-19-second-wave-restrictions-mclean-pkg-intl-ldn-vpx.cnn/video/playlists/coronavirus-intl/","description":"Coronavirus cases continue to rise across Europe and citizens face renewed restrictions as governments try to suppress the spread of the virus. CNN's Scott McLean reports.","descriptionText":"Coronavirus cases continue to rise across Europe and citizens face renewed restrictions as governments try to suppress the spread of the virus. CNN's Scott McLean reports."},{"title":"Czech Republic sees record number of Covid-19 cases","duration":"03:11","sourceName":"CNN","sourceLink":"https://www.cnn.com/","videoCMSUrl":"/video/data/3.0/video/world/2020/10/19/europe-czech-republic-coronavirus-covid-19-surge-mclean-pkg-intl-hnk-vpx.cnn/index.xml","videoId":"world/2020/10/19/europe-czech-republic-coronavirus-covid-19-surge-mclean-pkg-intl-hnk-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/201019105329-europe-czech-republic-coronavirus-covid-19-surge-mclean-pkg-intl-hnk-vpx-00012004-large-169.jpg","videoUrl":"/videos/world/2020/10/19/europe-czech-republic-coronavirus-covid-19-surge-mclean-pkg-intl-hnk-vpx.cnn/video/playlists/coronavirus-intl/","description":"In March, Czech Republic's face mask mandate helped them crush the coronavirus. But as the virus comes back, the country is recording the most cases per capita in Europe. What has gone wrong in Czech? CNN's Scott McLean reports. ","descriptionText":"In March, Czech Republic's face mask mandate helped them crush the coronavirus. But as the virus comes back, the country is recording the most cases per capita in Europe. What has gone wrong in Czech? CNN's Scott McLean reports. "},{"title":"Step inside a 'flight to nowhere'","duration":"01:33","sourceName":"CNN","sourceLink":"","videoCMSUrl":"/video/data/3.0/video/travel/2020/10/16/flights-to-nowhere-pandemic-travel-lon-orig-na.cnn/index.xml","videoId":"travel/2020/10/16/flights-to-nowhere-pandemic-travel-lon-orig-na.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/201012085516-01-qantas-flight-to-nowhere-passenger-experience-restricted-large-169.jpg","videoUrl":"/videos/travel/2020/10/16/flights-to-nowhere-pandemic-travel-lon-orig-na.cnn/video/playlists/coronavirus-intl/","description":"With travel restrictions due to Covid-19, airlines are offering "Flights to nowhere" that allow passengers to board planes, enjoy the trip and disembark at the same location. Take a look at what it's like.","descriptionText":"With travel restrictions due to Covid-19, airlines are offering "Flights to nowhere" that allow passengers to board planes, enjoy the trip and disembark at the same location. Take a look at what it's like."},{"title":"Hear from WHO's regional director for Europe amid surge in cases","duration":"02:23","sourceName":"CNN","sourceLink":"www.cnn.com","videoCMSUrl":"/video/data/3.0/video/world/2020/10/16/world-health-organization-europe-coronavirus-covid-19-surge-anderson-intv-ctw-intl-ldn-vpx.cnn/index.xml","videoId":"world/2020/10/16/world-health-organization-europe-coronavirus-covid-19-surge-anderson-intv-ctw-intl-ldn-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/201016155622-who-europe-director-hans-kluge-connect-the-world-10162020-large-169.jpg","videoUrl":"/videos/world/2020/10/16/world-health-organization-europe-coronavirus-covid-19-surge-anderson-intv-ctw-intl-ldn-vpx.cnn/video/playlists/coronavirus-intl/","description":"CNN's Becky Anderson speaks with the World Health Organization's Europe director Hans Kluge as countries smash records for daily coronavirus cases and the WHO warns that the daily death toll on the continent could reach five times its April peak within months.","descriptionText":"CNN's Becky Anderson speaks with the World Health Organization's Europe director Hans Kluge as countries smash records for daily coronavirus cases and the WHO warns that the daily death toll on the continent could reach five times its April peak within months."},{"title":"See Queen Elizabeth's first royal engagement since pandemic began ","duration":"00:59","sourceName":"CNN","sourceLink":"https://www.cnn.com/","videoCMSUrl":"/video/data/3.0/video/world/2020/10/16/uk-queen-elizabeth-ii-first-appearance-without-face-mask-stewart-lok-intl-hnk-vpx.cnn/index.xml","videoId":"world/2020/10/16/uk-queen-elizabeth-ii-first-appearance-without-face-mask-stewart-lok-intl-hnk-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/201016155049-uk-queen-elizabeth-ii-first-appearance-without-face-mask-stewart-lok-intl-hnk-vpx-00003515-large-169.jpg","videoUrl":"/videos/world/2020/10/16/uk-queen-elizabeth-ii-first-appearance-without-face-mask-stewart-lok-intl-hnk-vpx.cnn/video/playlists/coronavirus-intl/","description":"Queen Elizabeth II'su003ca href="https://edition.cnn.com/2020/10/15/europe/queen-elizabeth-mask-intl-scli-gbr/index.html" target="_blank"> first public engagement u003c/a>since the UK's national lockdown earlier this year has raised eyebrows, as neither the 94-year-old monarch nor Prince William wore masks. CNN's Anna Stewart reports. ","descriptionText":"Queen Elizabeth II'su003ca href="https://edition.cnn.com/2020/10/15/europe/queen-elizabeth-mask-intl-scli-gbr/index.html" target="_blank"> first public engagement u003c/a>since the UK's national lockdown earlier this year has raised eyebrows, as neither the 94-year-old monarch nor Prince William wore masks. CNN's Anna Stewart reports. "},{"title":"How new coronavirus restrictions in Paris and London will work","duration":"04:38","sourceName":"CNN","sourceLink":"https://www.cnn.com/?refresh=1","videoCMSUrl":"/video/data/3.0/video/world/2020/10/15/paris-france-london-england-coronavirus-restrictions-pandemic-ctw-intl-ldn-vpx.cnn/index.xml","videoId":"world/2020/10/15/paris-france-london-england-coronavirus-restrictions-pandemic-ctw-intl-ldn-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/201015044112-01-europe-coronavirus-paris-curfew-large-169.jpg","videoUrl":"/videos/world/2020/10/15/paris-france-london-england-coronavirus-restrictions-pandemic-ctw-intl-ldn-vpx.cnn/video/playlists/coronavirus-intl/","description":"Two of Europe's biggest capitals are in trouble as Paris imposed overnight curfews and London banned people from different households from meeting indoors to combat the spread of coronavirus. CNN's Melissa Bell and Phil Black report.","descriptionText":"Two of Europe's biggest capitals are in trouble as Paris imposed overnight curfews and London banned people from different households from meeting indoors to combat the spread of coronavirus. CNN's Melissa Bell and Phil Black report."},{"title":"Israeli group takes advantage of lockdown to clean up river. See what they did","duration":"02:09","sourceName":"CNN","sourceLink":"https://www.cnn.com","videoCMSUrl":"/video/data/3.0/video/world/2020/10/14/israel-coronavirus-lockdown-river-cleaning-environment-liebermann-pkg-intl-ldn-vpx.cnn/index.xml","videoId":"world/2020/10/14/israel-coronavirus-lockdown-river-cleaning-environment-liebermann-pkg-intl-ldn-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/201014103613-israel-river-cleaning-liebermann-large-169.jpg","videoUrl":"/videos/world/2020/10/14/israel-coronavirus-lockdown-river-cleaning-environment-liebermann-pkg-intl-ldn-vpx.cnn/video/playlists/coronavirus-intl/","description":"Israel is in the midst of its second general lockdown, but one group has treated this as a rare opportunity to clean the pollution out of one of Israel's rivers, diving into the murky water to pull out bottles, chairs, tables, tires and more. CNN's Oren Liebermann reports.","descriptionText":"Israel is in the midst of its second general lockdown, but one group has treated this as a rare opportunity to clean the pollution out of one of Israel's rivers, diving into the murky water to pull out bottles, chairs, tables, tires and more. CNN's Oren Liebermann reports."},{"title":"Liverpool becomes first city to be placed under UK's tightest restrictions","duration":"02:15","sourceName":"CNN","sourceLink":"https://www.cnn.com/","videoCMSUrl":"/video/data/3.0/video/world/2020/10/14/uk-liverpool-coronavirus-covid-19-tier-3-lockdown-abdelaziz-pkg-intl-hnk-vpx.cnn/index.xml","videoId":"world/2020/10/14/uk-liverpool-coronavirus-covid-19-tier-3-lockdown-abdelaziz-pkg-intl-hnk-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/201014135432-screengrab-liverpool-lockdown2-large-169.jpg","videoUrl":"/videos/world/2020/10/14/uk-liverpool-coronavirus-covid-19-tier-3-lockdown-abdelaziz-pkg-intl-hnk-vpx.cnn/video/playlists/coronavirus-intl/","description":"The city of Liverpool in northern England is part of the first area to go under the UK's new strictest set of Covid-19 restrictions. CNN's Salma Abdelaziz reports. ","descriptionText":"The city of Liverpool in northern England is part of the first area to go under the UK's new strictest set of Covid-19 restrictions. CNN's Salma Abdelaziz reports. "},{"title":"These European countries are seeing record rises in Covid-19 cases","duration":"02:43","sourceName":"CNN","sourceLink":"https://www.cnn.com","videoCMSUrl":"/video/data/3.0/video/world/2020/10/13/europe-coronavirus-covid-19-cases-second-wave-vanier-pkg-intl-ldn-vpx.cnn/index.xml","videoId":"world/2020/10/13/europe-coronavirus-covid-19-cases-second-wave-vanier-pkg-intl-ldn-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/201013104619-europe-coronavirus-covid-19-cases-second-wave-vanier-pkg-intl-ldn-vpx-00020724-large-169.jpg","videoUrl":"/videos/world/2020/10/13/europe-coronavirus-covid-19-cases-second-wave-vanier-pkg-intl-ldn-vpx.cnn/video/playlists/coronavirus-intl/","description":"Europe is now reporting more daily infections than the United States, Brazil, or India - the countries that have been driving the global case count for months - as public apathy grows towards coronavirus guidelines. CNN's Cyril Vanier reports.","descriptionText":"Europe is now reporting more daily infections than the United States, Brazil, or India - the countries that have been driving the global case count for months - as public apathy grows towards coronavirus guidelines. CNN's Cyril Vanier reports."},{"title":"England takes cautious approach to enforcing Covid-19 rules","duration":"03:45","sourceName":"CNN","sourceLink":"https://www.cnn.com","videoCMSUrl":"/video/data/3.0/video/world/2020/10/13/england-coronavirus-covid-19-rules-enforcement-mclean-pkg-intl-ldn-vpx.cnn/index.xml","videoId":"world/2020/10/13/england-coronavirus-covid-19-rules-enforcement-mclean-pkg-intl-ldn-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/201013100400-england-coronavirus-covid-19-rules-enforcement-mclean-pkg-intl-ldn-vpx-00022505-large-169.jpg","videoUrl":"/videos/world/2020/10/13/england-coronavirus-covid-19-rules-enforcement-mclean-pkg-intl-ldn-vpx.cnn/video/playlists/coronavirus-intl/","description":"The British government has instituted increased Covid-19 restrictions over the past few weeks, which many Brits appear to be ignoring. Only 89 fines have been issued for mask violations and 38 for breaking travel quarantine in England and Wales, according to the National Police Chiefs' Council. CNN's Scott McLean reports.","descriptionText":"The British government has instituted increased Covid-19 restrictions over the past few weeks, which many Brits appear to be ignoring. Only 89 fines have been issued for mask violations and 38 for breaking travel quarantine in England and Wales, according to the National Police Chiefs' Council. CNN's Scott McLean reports."},{"title":"Meet the Michelin star chef who feeds millions amid pandemic ","duration":"02:29","sourceName":"CNN","sourceLink":"https://www.cnn.com/","videoCMSUrl":"/video/data/3.0/video/world/2020/10/12/feed-india-michelin-star-chef-vikas-khanna-coronavirus-covid-19-sud-pkg-intl-hnk-vpx.cnn/index.xml","videoId":"world/2020/10/12/feed-india-michelin-star-chef-vikas-khanna-coronavirus-covid-19-sud-pkg-intl-hnk-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/201012110137-feed-india-michelin-star-chef-vikas-khanna-coronavirus-covid-19-sud-pkg-intl-hnk-vpx-00000228-large-169.jpg","videoUrl":"/videos/world/2020/10/12/feed-india-michelin-star-chef-vikas-khanna-coronavirus-covid-19-sud-pkg-intl-hnk-vpx.cnn/video/playlists/coronavirus-intl/","description":"Vikas Khanna is an Indian celebrity chef who has cooked for the Obamas. But he says no experience is more rewarding than feeding millions of underprivileged fellow Indians. Ever since India's first lockdown, the Michelin-starred chef, based in New York City, has delivered over 40 million meals across India. CNN's Vedika Sud reports. ","descriptionText":"Vikas Khanna is an Indian celebrity chef who has cooked for the Obamas. But he says no experience is more rewarding than feeding millions of underprivileged fellow Indians. Ever since India's first lockdown, the Michelin-starred chef, based in New York City, has delivered over 40 million meals across India. CNN's Vedika Sud reports. "},{"title":"Why she is volunteering to get infected with Covid-19 ","duration":"03:26","sourceName":"CNN","sourceLink":"https://www.cnn.com/","videoCMSUrl":"/video/data/3.0/video/world/2020/10/11/vaccine-challenge-trial-black-pkg-vpx.cnn/index.xml","videoId":"world/2020/10/11/vaccine-challenge-trial-black-pkg-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/201011075438-vaccine-challenge-trial-black-pkg-vpx-00001618-large-169.jpg","videoUrl":"/videos/world/2020/10/11/vaccine-challenge-trial-black-pkg-vpx.cnn/video/playlists/coronavirus-intl/","description":"Citizens in the UK are asking the government for the chance to be deliberately infected with the coronavirus through challenge trials in the hopes of improving the development of a vaccine. ","descriptionText":"Citizens in the UK are asking the government for the chance to be deliberately infected with the coronavirus through challenge trials in the hopes of improving the development of a vaccine. "},{"title":"Anti-lockdown protests across Europe despite surge in cases","duration":"02:04","sourceName":"CNN","sourceLink":"https://www.cnn.com/","videoCMSUrl":"/video/data/3.0/video/world/2020/10/12/europe-anti-lockdown-protest-coronavirus-covid-19-soares-pkg-intl-hnk-vpx.cnn/index.xml","videoId":"world/2020/10/12/europe-anti-lockdown-protest-coronavirus-covid-19-soares-pkg-intl-hnk-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/201012151637-screengrab-europe-covid-protest-wrap-2-large-169.jpg","videoUrl":"/videos/world/2020/10/12/europe-anti-lockdown-protest-coronavirus-covid-19-soares-pkg-intl-hnk-vpx.cnn/video/playlists/coronavirus-intl/","description":"As Covid-19 cases rise in Europe, protests against government restrictions and lockdowns are popping up across the continent. u003ca href="http://www.cnn.com/profiles/isa-soares" target="_blank">CNN's Isa Soaresu003c/a> reports. ","descriptionText":"As Covid-19 cases rise in Europe, protests against government restrictions and lockdowns are popping up across the continent. u003ca href="http://www.cnn.com/profiles/isa-soares" target="_blank">CNN's Isa Soaresu003c/a> reports. "}],currentVideoCollectionId = '',isLivePlayer = false,mediaMetadataCallbacks,mobilePinnedView = null,moveToNextTimeout,mutePlayerEnabled = false,nextVideoId = '',nextVideoUrl = '',turnOnFlashMessaging = false,videoPinner,videoEndSlateImpl;if (CNN.autoPlayVideoExist === false) {autoStartVideo = true;if (autoStartVideo === true) {if (turnOnFlashMessaging === true) {autoStartVideo = false;containerEl = jQuery(document.getElementById(configObj.markupId));CNN.VideoPlayer.showFlashSlate(containerEl);} else {CNN.autoPlayVideoExist = true;}}}configObj.autostart = CNN.Features.enableAutoplayBlock ? false : autoStartVideo;CNN.VideoPlayer.setPlayerProperties(configObj.markupId, autoStartVideo, isLivePlayer, isVideoReplayClicked, mutePlayerEnabled);CNN.VideoPlayer.setFirstVideoInCollection(currentVideoCollection, configObj.markupId);var videoHandler = {},isFeaturedVideoCollectionHandlerAvailable = (CNN !== undefined &&CNN.VIDEOCLIENT !== undefined &&CNN.VIDEOCLIENT.FeaturedVideoCollectionHandler !== undefined);if (!isFeaturedVideoCollectionHandlerAvailable) {CNN.INJECTOR.executeFeature('videx').done(function () {jQuery.ajax({dataType: 'script',cache: true,url: '//www.i.cdn.cnn.com/.a/2.241.3/js/featured-video-collection-player.min.js'}).done(function () {initializeVideoAndCollection();}).fail(function () {throw 'Unable to fetch /js/featured-video-collection-player.min.js';});}).fail(function () {throw 'Unable to fetch the videx bundle';});}function initializeVideoAndCollection() {videoHandler = new CNN.VIDEOCLIENT.FeaturedVideoCollectionHandler(configObj.markupId,"cn-featured-su4x22",'js-video_description-featured-su4x22',[{"title":"Hong Kong researchers say man got Covid-19 twice","duration":"03:34","sourceName":"CNN","sourceLink":"https://cnn.com","videoCMSUrl":"/video/data/3.0/video/health/2020/08/24/first-documented-coronavirus-reinfection-case-hong-kong-pkg-tsr-vpx.cnn/index.xml","videoId":"health/2020/08/24/first-documented-coronavirus-reinfection-case-hong-kong-pkg-tsr-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/200824190746-coronavirus-large-169.jpg","videoUrl":"/videos/health/2020/08/24/first-documented-coronavirus-reinfection-case-hong-kong-pkg-tsr-vpx.cnn/video/playlists/coronavirus-intl/","description":"With the US death toll from coronavirus passing 177,000, researchers in China say a 33-year-old man living in in Hong Kong is the first person confirmed to have been reinfected with the virus. CNN's Brian Todd reports.","descriptionText":"With the US death toll from coronavirus passing 177,000, researchers in China say a 33-year-old man living in in Hong Kong is the first person confirmed to have been reinfected with the virus. CNN's Brian Todd reports."},{"title":"This area was already in isolation. Then came the Covid-19 lockdown","duration":"03:14","sourceName":"CNN","sourceLink":"https://www.cnn.com/","videoCMSUrl":"/video/data/3.0/video/world/2020/10/19/gaza-coronavirus-covid-19-blockaded-nat-sot-pkg-intl-hnk-vpx.cnn/index.xml","videoId":"world/2020/10/19/gaza-coronavirus-covid-19-blockaded-nat-sot-pkg-intl-hnk-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/201019094504-gaza-coronavirus-covid-19-blockaded-nat-sot-pkg-intl-hnk-vpx-00000000-large-169.jpg","videoUrl":"/videos/world/2020/10/19/gaza-coronavirus-covid-19-blockaded-nat-sot-pkg-intl-hnk-vpx.cnn/video/playlists/coronavirus-intl/","description":"The Gaza Strip is one of the most densely-populated areas in the world. After more than a decade under blockade, the Covid-19 lockdown is adding isolation and despair to the area. ","descriptionText":"The Gaza Strip is one of the most densely-populated areas in the world. After more than a decade under blockade, the Covid-19 lockdown is adding isolation and despair to the area. "},{"title":"Italy's second coronavirus wave feels different. Here's why","duration":"02:09","sourceName":"CNN","sourceLink":"https://www.cnn.com","videoCMSUrl":"/video/data/3.0/video/world/2020/10/19/italy-naples-coronavirus-covid-19-testing-wedeman-pkg-intl-ldn-vpx.cnn/index.xml","videoId":"world/2020/10/19/italy-naples-coronavirus-covid-19-testing-wedeman-pkg-intl-ldn-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/201019110927-italy-naples-coronavirus-covid-19-testing-wedeman-pkg-intl-ldn-vpx-00011514-large-169.jpg","videoUrl":"/videos/world/2020/10/19/italy-naples-coronavirus-covid-19-testing-wedeman-pkg-intl-ldn-vpx.cnn/video/playlists/coronavirus-intl/","description":"Italy recorded a record number of positive coronavirus tests for the fifth day running on October 18, but in a marked contrast to the 'first wave', the number of patients in intensive care remains relatively low. CNN's Ben Wedeman reports from Naples.","descriptionText":"Italy recorded a record number of positive coronavirus tests for the fifth day running on October 18, but in a marked contrast to the 'first wave', the number of patients in intensive care remains relatively low. CNN's Ben Wedeman reports from Naples."},{"title":"Tougher Covid-19 restrictions are once again the norm in Europe","duration":"01:58","sourceName":"CNN","sourceLink":"https://www.cnn.com","videoCMSUrl":"/video/data/3.0/video/world/2020/10/19/europe-england-france-poland-coronavirus-covid-19-second-wave-restrictions-mclean-pkg-intl-ldn-vpx.cnn/index.xml","videoId":"world/2020/10/19/europe-england-france-poland-coronavirus-covid-19-second-wave-restrictions-mclean-pkg-intl-ldn-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/201019102301-europe-covid-19-restrictions-mclean-pkg-10192020-large-169.jpg","videoUrl":"/videos/world/2020/10/19/europe-england-france-poland-coronavirus-covid-19-second-wave-restrictions-mclean-pkg-intl-ldn-vpx.cnn/video/playlists/coronavirus-intl/","description":"Coronavirus cases continue to rise across Europe and citizens face renewed restrictions as governments try to suppress the spread of the virus. CNN's Scott McLean reports.","descriptionText":"Coronavirus cases continue to rise across Europe and citizens face renewed restrictions as governments try to suppress the spread of the virus. CNN's Scott McLean reports."},{"title":"Czech Republic sees record number of Covid-19 cases","duration":"03:11","sourceName":"CNN","sourceLink":"https://www.cnn.com/","videoCMSUrl":"/video/data/3.0/video/world/2020/10/19/europe-czech-republic-coronavirus-covid-19-surge-mclean-pkg-intl-hnk-vpx.cnn/index.xml","videoId":"world/2020/10/19/europe-czech-republic-coronavirus-covid-19-surge-mclean-pkg-intl-hnk-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/201019105329-europe-czech-republic-coronavirus-covid-19-surge-mclean-pkg-intl-hnk-vpx-00012004-large-169.jpg","videoUrl":"/videos/world/2020/10/19/europe-czech-republic-coronavirus-covid-19-surge-mclean-pkg-intl-hnk-vpx.cnn/video/playlists/coronavirus-intl/","description":"In March, Czech Republic's face mask mandate helped them crush the coronavirus. But as the virus comes back, the country is recording the most cases per capita in Europe. What has gone wrong in Czech? CNN's Scott McLean reports. ","descriptionText":"In March, Czech Republic's face mask mandate helped them crush the coronavirus. But as the virus comes back, the country is recording the most cases per capita in Europe. What has gone wrong in Czech? CNN's Scott McLean reports. "},{"title":"Step inside a 'flight to nowhere'","duration":"01:33","sourceName":"CNN","sourceLink":"","videoCMSUrl":"/video/data/3.0/video/travel/2020/10/16/flights-to-nowhere-pandemic-travel-lon-orig-na.cnn/index.xml","videoId":"travel/2020/10/16/flights-to-nowhere-pandemic-travel-lon-orig-na.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/201012085516-01-qantas-flight-to-nowhere-passenger-experience-restricted-large-169.jpg","videoUrl":"/videos/travel/2020/10/16/flights-to-nowhere-pandemic-travel-lon-orig-na.cnn/video/playlists/coronavirus-intl/","description":"With travel restrictions due to Covid-19, airlines are offering "Flights to nowhere" that allow passengers to board planes, enjoy the trip and disembark at the same location. Take a look at what it's like.","descriptionText":"With travel restrictions due to Covid-19, airlines are offering "Flights to nowhere" that allow passengers to board planes, enjoy the trip and disembark at the same location. Take a look at what it's like."},{"title":"Hear from WHO's regional director for Europe amid surge in cases","duration":"02:23","sourceName":"CNN","sourceLink":"www.cnn.com","videoCMSUrl":"/video/data/3.0/video/world/2020/10/16/world-health-organization-europe-coronavirus-covid-19-surge-anderson-intv-ctw-intl-ldn-vpx.cnn/index.xml","videoId":"world/2020/10/16/world-health-organization-europe-coronavirus-covid-19-surge-anderson-intv-ctw-intl-ldn-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/201016155622-who-europe-director-hans-kluge-connect-the-world-10162020-large-169.jpg","videoUrl":"/videos/world/2020/10/16/world-health-organization-europe-coronavirus-covid-19-surge-anderson-intv-ctw-intl-ldn-vpx.cnn/video/playlists/coronavirus-intl/","description":"CNN's Becky Anderson speaks with the World Health Organization's Europe director Hans Kluge as countries smash records for daily coronavirus cases and the WHO warns that the daily death toll on the continent could reach five times its April peak within months.","descriptionText":"CNN's Becky Anderson speaks with the World Health Organization's Europe director Hans Kluge as countries smash records for daily coronavirus cases and the WHO warns that the daily death toll on the continent could reach five times its April peak within months."},{"title":"See Queen Elizabeth's first royal engagement since pandemic began ","duration":"00:59","sourceName":"CNN","sourceLink":"https://www.cnn.com/","videoCMSUrl":"/video/data/3.0/video/world/2020/10/16/uk-queen-elizabeth-ii-first-appearance-without-face-mask-stewart-lok-intl-hnk-vpx.cnn/index.xml","videoId":"world/2020/10/16/uk-queen-elizabeth-ii-first-appearance-without-face-mask-stewart-lok-intl-hnk-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/201016155049-uk-queen-elizabeth-ii-first-appearance-without-face-mask-stewart-lok-intl-hnk-vpx-00003515-large-169.jpg","videoUrl":"/videos/world/2020/10/16/uk-queen-elizabeth-ii-first-appearance-without-face-mask-stewart-lok-intl-hnk-vpx.cnn/video/playlists/coronavirus-intl/","description":"Queen Elizabeth II'su003ca href="https://edition.cnn.com/2020/10/15/europe/queen-elizabeth-mask-intl-scli-gbr/index.html" target="_blank"> first public engagement u003c/a>since the UK's national lockdown earlier this year has raised eyebrows, as neither the 94-year-old monarch nor Prince William wore masks. CNN's Anna Stewart reports. ","descriptionText":"Queen Elizabeth II'su003ca href="https://edition.cnn.com/2020/10/15/europe/queen-elizabeth-mask-intl-scli-gbr/index.html" target="_blank"> first public engagement u003c/a>since the UK's national lockdown earlier this year has raised eyebrows, as neither the 94-year-old monarch nor Prince William wore masks. CNN's Anna Stewart reports. "},{"title":"How new coronavirus restrictions in Paris and London will work","duration":"04:38","sourceName":"CNN","sourceLink":"https://www.cnn.com/?refresh=1","videoCMSUrl":"/video/data/3.0/video/world/2020/10/15/paris-france-london-england-coronavirus-restrictions-pandemic-ctw-intl-ldn-vpx.cnn/index.xml","videoId":"world/2020/10/15/paris-france-london-england-coronavirus-restrictions-pandemic-ctw-intl-ldn-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/201015044112-01-europe-coronavirus-paris-curfew-large-169.jpg","videoUrl":"/videos/world/2020/10/15/paris-france-london-england-coronavirus-restrictions-pandemic-ctw-intl-ldn-vpx.cnn/video/playlists/coronavirus-intl/","description":"Two of Europe's biggest capitals are in trouble as Paris imposed overnight curfews and London banned people from different households from meeting indoors to combat the spread of coronavirus. CNN's Melissa Bell and Phil Black report.","descriptionText":"Two of Europe's biggest capitals are in trouble as Paris imposed overnight curfews and London banned people from different households from meeting indoors to combat the spread of coronavirus. CNN's Melissa Bell and Phil Black report."},{"title":"Israeli group takes advantage of lockdown to clean up river. See what they did","duration":"02:09","sourceName":"CNN","sourceLink":"https://www.cnn.com","videoCMSUrl":"/video/data/3.0/video/world/2020/10/14/israel-coronavirus-lockdown-river-cleaning-environment-liebermann-pkg-intl-ldn-vpx.cnn/index.xml","videoId":"world/2020/10/14/israel-coronavirus-lockdown-river-cleaning-environment-liebermann-pkg-intl-ldn-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/201014103613-israel-river-cleaning-liebermann-large-169.jpg","videoUrl":"/videos/world/2020/10/14/israel-coronavirus-lockdown-river-cleaning-environment-liebermann-pkg-intl-ldn-vpx.cnn/video/playlists/coronavirus-intl/","description":"Israel is in the midst of its second general lockdown, but one group has treated this as a rare opportunity to clean the pollution out of one of Israel's rivers, diving into the murky water to pull out bottles, chairs, tables, tires and more. CNN's Oren Liebermann reports.","descriptionText":"Israel is in the midst of its second general lockdown, but one group has treated this as a rare opportunity to clean the pollution out of one of Israel's rivers, diving into the murky water to pull out bottles, chairs, tables, tires and more. CNN's Oren Liebermann reports."},{"title":"Liverpool becomes first city to be placed under UK's tightest restrictions","duration":"02:15","sourceName":"CNN","sourceLink":"https://www.cnn.com/","videoCMSUrl":"/video/data/3.0/video/world/2020/10/14/uk-liverpool-coronavirus-covid-19-tier-3-lockdown-abdelaziz-pkg-intl-hnk-vpx.cnn/index.xml","videoId":"world/2020/10/14/uk-liverpool-coronavirus-covid-19-tier-3-lockdown-abdelaziz-pkg-intl-hnk-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/201014135432-screengrab-liverpool-lockdown2-large-169.jpg","videoUrl":"/videos/world/2020/10/14/uk-liverpool-coronavirus-covid-19-tier-3-lockdown-abdelaziz-pkg-intl-hnk-vpx.cnn/video/playlists/coronavirus-intl/","description":"The city of Liverpool in northern England is part of the first area to go under the UK's new strictest set of Covid-19 restrictions. CNN's Salma Abdelaziz reports. ","descriptionText":"The city of Liverpool in northern England is part of the first area to go under the UK's new strictest set of Covid-19 restrictions. CNN's Salma Abdelaziz reports. "},{"title":"These European countries are seeing record rises in Covid-19 cases","duration":"02:43","sourceName":"CNN","sourceLink":"https://www.cnn.com","videoCMSUrl":"/video/data/3.0/video/world/2020/10/13/europe-coronavirus-covid-19-cases-second-wave-vanier-pkg-intl-ldn-vpx.cnn/index.xml","videoId":"world/2020/10/13/europe-coronavirus-covid-19-cases-second-wave-vanier-pkg-intl-ldn-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/201013104619-europe-coronavirus-covid-19-cases-second-wave-vanier-pkg-intl-ldn-vpx-00020724-large-169.jpg","videoUrl":"/videos/world/2020/10/13/europe-coronavirus-covid-19-cases-second-wave-vanier-pkg-intl-ldn-vpx.cnn/video/playlists/coronavirus-intl/","description":"Europe is now reporting more daily infections than the United States, Brazil, or India - the countries that have been driving the global case count for months - as public apathy grows towards coronavirus guidelines. CNN's Cyril Vanier reports.","descriptionText":"Europe is now reporting more daily infections than the United States, Brazil, or India - the countries that have been driving the global case count for months - as public apathy grows towards coronavirus guidelines. CNN's Cyril Vanier reports."},{"title":"England takes cautious approach to enforcing Covid-19 rules","duration":"03:45","sourceName":"CNN","sourceLink":"https://www.cnn.com","videoCMSUrl":"/video/data/3.0/video/world/2020/10/13/england-coronavirus-covid-19-rules-enforcement-mclean-pkg-intl-ldn-vpx.cnn/index.xml","videoId":"world/2020/10/13/england-coronavirus-covid-19-rules-enforcement-mclean-pkg-intl-ldn-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/201013100400-england-coronavirus-covid-19-rules-enforcement-mclean-pkg-intl-ldn-vpx-00022505-large-169.jpg","videoUrl":"/videos/world/2020/10/13/england-coronavirus-covid-19-rules-enforcement-mclean-pkg-intl-ldn-vpx.cnn/video/playlists/coronavirus-intl/","description":"The British government has instituted increased Covid-19 restrictions over the past few weeks, which many Brits appear to be ignoring. Only 89 fines have been issued for mask violations and 38 for breaking travel quarantine in England and Wales, according to the National Police Chiefs' Council. CNN's Scott McLean reports.","descriptionText":"The British government has instituted increased Covid-19 restrictions over the past few weeks, which many Brits appear to be ignoring. Only 89 fines have been issued for mask violations and 38 for breaking travel quarantine in England and Wales, according to the National Police Chiefs' Council. CNN's Scott McLean reports."},{"title":"Meet the Michelin star chef who feeds millions amid pandemic ","duration":"02:29","sourceName":"CNN","sourceLink":"https://www.cnn.com/","videoCMSUrl":"/video/data/3.0/video/world/2020/10/12/feed-india-michelin-star-chef-vikas-khanna-coronavirus-covid-19-sud-pkg-intl-hnk-vpx.cnn/index.xml","videoId":"world/2020/10/12/feed-india-michelin-star-chef-vikas-khanna-coronavirus-covid-19-sud-pkg-intl-hnk-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/201012110137-feed-india-michelin-star-chef-vikas-khanna-coronavirus-covid-19-sud-pkg-intl-hnk-vpx-00000228-large-169.jpg","videoUrl":"/videos/world/2020/10/12/feed-india-michelin-star-chef-vikas-khanna-coronavirus-covid-19-sud-pkg-intl-hnk-vpx.cnn/video/playlists/coronavirus-intl/","description":"Vikas Khanna is an Indian celebrity chef who has cooked for the Obamas. But he says no experience is more rewarding than feeding millions of underprivileged fellow Indians. Ever since India's first lockdown, the Michelin-starred chef, based in New York City, has delivered over 40 million meals across India. CNN's Vedika Sud reports. ","descriptionText":"Vikas Khanna is an Indian celebrity chef who has cooked for the Obamas. But he says no experience is more rewarding than feeding millions of underprivileged fellow Indians. Ever since India's first lockdown, the Michelin-starred chef, based in New York City, has delivered over 40 million meals across India. CNN's Vedika Sud reports. "},{"title":"Why she is volunteering to get infected with Covid-19 ","duration":"03:26","sourceName":"CNN","sourceLink":"https://www.cnn.com/","videoCMSUrl":"/video/data/3.0/video/world/2020/10/11/vaccine-challenge-trial-black-pkg-vpx.cnn/index.xml","videoId":"world/2020/10/11/vaccine-challenge-trial-black-pkg-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/201011075438-vaccine-challenge-trial-black-pkg-vpx-00001618-large-169.jpg","videoUrl":"/videos/world/2020/10/11/vaccine-challenge-trial-black-pkg-vpx.cnn/video/playlists/coronavirus-intl/","description":"Citizens in the UK are asking the government for the chance to be deliberately infected with the coronavirus through challenge trials in the hopes of improving the development of a vaccine. ","descriptionText":"Citizens in the UK are asking the government for the chance to be deliberately infected with the coronavirus through challenge trials in the hopes of improving the development of a vaccine. "},{"title":"Anti-lockdown protests across Europe despite surge in cases","duration":"02:04","sourceName":"CNN","sourceLink":"https://www.cnn.com/","videoCMSUrl":"/video/data/3.0/video/world/2020/10/12/europe-anti-lockdown-protest-coronavirus-covid-19-soares-pkg-intl-hnk-vpx.cnn/index.xml","videoId":"world/2020/10/12/europe-anti-lockdown-protest-coronavirus-covid-19-soares-pkg-intl-hnk-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/201012151637-screengrab-europe-covid-protest-wrap-2-large-169.jpg","videoUrl":"/videos/world/2020/10/12/europe-anti-lockdown-protest-coronavirus-covid-19-soares-pkg-intl-hnk-vpx.cnn/video/playlists/coronavirus-intl/","description":"As Covid-19 cases rise in Europe, protests against government restrictions and lockdowns are popping up across the continent. u003ca href="http://www.cnn.com/profiles/isa-soares" target="_blank">CNN's Isa Soaresu003c/a> reports. ","descriptionText":"As Covid-19 cases rise in Europe, protests against government restrictions and lockdowns are popping up across the continent. u003ca href="http://www.cnn.com/profiles/isa-soares" target="_blank">CNN's Isa Soaresu003c/a> reports. "}],'js-video_headline-featured-su4x22','',"js-video_source-featured-su4x22",true,true,'coronavirus-intl');if (typeof configObj.context !== 'string' || configObj.context.length

Read the rest here:

Covid-19: Dutch woman who caught virus twice dies - CNN

COVID-19: Two heath workers, 10 others contract virus in Ondo

The Ondo State Government has said 12 new cases of the Covid-19 infection have been recorded in the state.

Two of the number are health workers from Akoko South East local government area.

The Acting Commissioner for Health in the State, Jibayo Adeyeye, gave the details while addressing journalists in Akure on Wednesday.

According to him, four cases were recorded in Akoko South-East, three from Akure South, one from Ile Oluji/ Okeigbo; one from Ose, one from Owo, one from Idanre and one in Okitipupa.

He also noted that seven of them were asymptomatic.

He said Ondo has a total of 1651 confirmed COVID-19 cases; with 25 active confirmed cases and 36 deaths.

In spite of this, the Governor of the state, Oluwarotimi Akeredolu, has approved the resumption of all schools in the state on Monday, 19th of October, 2020.

He, however, directed that all schools must abide by the COVID-19 preventive guidelines released by the Ondo State Inter-ministerial Committee to ensure the safety of staff and students.

Chairperson of the Inter-ministerial Committee on Coronavirus (COVID-19), who is also the Vice-Chancellor, University of Medical Sciences, Ondo, Adesegun Fatusi, said that the governor had also instructed the Ondo State Inter-ministerial Committee to conduct periodic monitoring visit to schools and any school found not to be complying with the COVID-19 guidelines should be shut.

The guidelines include: Notices with the message, No Mask, No Entry, must be boldly displayed at the entrance of the school and at strategic spots throughout the school compound; Infrared thermometer must be made available and used to assess the temperature of each staff, student, and visitors at the point of entry into the schools.

Hand washing devices with an adequate and constant source of running water and soaps must be available in schools and all individuals must wash their hands when entering the schools. Alternatively, hand sanitisers with an alcohol content of not less than 70% may be used.

All individuals with high temperature or who show any form of illness must not be allowed into the school: written guidelines must be available in that regard.

Seats in the classrooms and staff rooms must be separated with a minimum space of two metres or 6 feet (two arms length).

A COVID-19 monitoring team must be established in each school with the responsibility for monitoring and ensuring full compliance of all staff and students with the above-stated guidelines.

Civil society organisations, which monitored the just concluded governorship election in the state, observed widespread non-compliance with COVID-19 protocols as directed by the Independent National Electoral Commission.

Advertisement

Link:

COVID-19: Two heath workers, 10 others contract virus in Ondo

Could certain COVID-19 vaccines leave people more vulnerable to the AIDS virus? – Science Magazine

CanSino Biologicss experimental COVID-19 vaccine is one of at least four using an adenovirus that some worry could increase HIV susceptibility.

By Jon CohenOct. 19, 2020 , 6:30 PM

Sciences COVID-19 reporting is supported by the Pulitzer Center and the Heising-Simons Foundation.

Certain COVID-19 vaccine candidates could increase susceptibility to HIV, warns a group of researchers who in 2007 learned that an experimental HIV vaccine had raised in some people the risk for infection with the AIDS virus. These concerns have percolated in the background of the race for a vaccine to stem the coronavirus pandemic, but now the researchers have gone public with a cautionary tale, in part because trials of those candidates may soon begin in locales that have pronounced HIV epidemics, such as South Africa.

Some approved and experimental vaccines have as a backbone a variety of adenoviruses, which can cause the common cold but are often harmless. The ill-fated HIV vaccine trial used an engineered strain known as adenovirus 5 (Ad5) to shuttle into the body the gene for the surface protein of the AIDS virus. In four candidate COVID-19 vaccines now in clinical trials in several countries, including the United States, Ad5 similarly serves as the vector to carry in the surface protein gene of SARS-CoV-2, the viral cause of the pandemic; two of these have advanced to large-scale, phase III efficacy studies in Russia and Pakistan.

In todays issue ofTheLancet, four veteran researchers raise a warning flag about those COVID-19 vaccine candidates by recounting their experience running a placebo-controlled AIDS vaccine trial dubbed STEP.An interim analysis of STEP found that uncircumcised men who had been naturally infected with Ad5 before receiving the vaccine became especially vulnerable to the AIDS virus. The vaccine, made by Merck, had been the leading hope for what was then a 20-year search for a shot that could thwart HIV. But after the STEP results appeared, the field went into a tailspin. It took a decade to recover, says one of the co-authors of theLancet correspondence, Lawrence Corey of the Fred Hutchinson Cancer Research Center.

Corey, who now co-leads the COVID-19 prevention network in the United States that is testing vaccines at the behest of the National Institutes of Health, says he and his co-authors went public because Ad5-based COVID-19 vaccines may soon be tested in populations with high HIV prevalence and thus a greater risk of accidental infection during a clinical trial. If I were in a sub-Saharan African country and making a decision as to what I would want for my country for a general population use of a SARS-CoV-2 vaccine, I dont see why I would pick an Ad5 vector [vaccine] when there are many other alternative choices, Corey says.

The backfire in STEPwhich evaluated the efficacy of the Merck vaccine in people at high risk of HIV infection in the Americas and Australiaalso appeared in a second study, dubbed Phambili, of the same vaccine. It was taking place simultaneously in South Africa and was stopped early because of the STEP data.

Precisely how Mercks Ad5 vaccine increased the risk of HIV transmission in STEP and Phambili remains murky. The Lancet editorial spells out several possibilities, including dampening of HIV immunity, enhancing replication of the AIDS virus, or setting up more target cells for it.

In addition to the Ad5 COVID-19 vaccine candidates, several other leading vaccines, including ones made by Johnson & Johnson and AstraZeneca/the University of Oxford, use different adenoviruses as vectors. Theres no evidence that any of those adenoviruses increases the risks of an HIV infection.

I dont see why I would pick an Ad5 vector [vaccine] when there are many other alternative choices.

Of the Ad5-based COVID-19 vaccine candidates, from China-based CanSino Biologics, has developed the furthest. In a Lancet report in May, researchers from the company recognized the controversial possibility of their vector increasing the risk of HIV infection and said they would watch for it in the candidates trials. CanSinos COVID-19 vaccine is being tested in efficacy trials in Russia and Pakistan that together hope to enroll more than 40,000 people, and the company is discussing starting studies in Saudi Arabia, Brazil, Chile, and Mexico.

China has already approved a CanSino vaccine against Ebola that uses the Ad5 vector. Yu Xuefeng, CanSinos CEO, tells Science the risk of increased HIV susceptibility may be limited to Ad5 vaccines that produce an AIDS virus protein. Theres no clear answer yet, Yu says. We certainly havent seen anything with the Ebola vaccine. The companys Ebola vaccine was tested in a population in Sierra Leone that, he notes, had a relatively high HIV prevalence, making it more likely to have detected the problem if it existed.

Russias Gamaleya Research Institute has a COVID-19 vaccine candidate that uses a combination of Ad5 and Ad26 vectors; its now in an efficacy trial in that country.

Last week, ImmunityBio received approval from the U.S. Food and Drug Administration to begin human trials of its COVID-19 vaccine, which uses Ad5 as a vector. The first trial will take place in Newport Beach, California, but Patrick Soon-Shiong, the companys CEO, says he also hopes to test it in South Africa, where he grew up and went to medical school.

He calls the STEP study results very, very fuzzy and stresses that ImmunityBios Ad5 has four deleted genes that reduce the immune responses it triggers. Its 90% muted, he says.

ImmunityBio is discussing the risks with scientists and regulators in South Africa of a trial there to test its modified Ad5 COVID-19 vaccine. The informed consent process for that proposed study would tell participants about potential risks given the previous STEP and Phambili results.

Soon-Shiong emphasizes that his companys experimental COVID-19 vaccine, unlike every other candidate that uses an adenovirus vector, presents two different SARS-CoV-2 genes and mighttherefore offer more protection from infection or disease. Why only test this in wealthy enclaves of Southern California, he asks? Why not South Africa? Why not for the underserved people of the world?

Pediatrician Glenda Gray, who heads the South African Medical Research Council and was the protocol chair of Phambili, has taken part in several discussions with the ImmunoBio team.When [Soon-Shiong] contacted South Africa, we were obviously quite concerned, Gray says. All of us who were in Phambili and quite traumatized by what happened asked whether there was an appetite to do something in South Africa.

But after several months of deliberations, the South Africans concluded that regulators should consider a small trial of the vaccine there in people at low risk of HIV infection, Gray says. We decided not to throw the baby out with the bath water just yet, she adds. If it does go ahead in South Africa, there has to be huge consultation with communities, and we have to make doubly sure that the participants understand what happened in the past.

Gray says South Africa appreciates ImmunoBios offer to allow the country to manufacture the product. Were in the middle of a COVID-19 epidemic in South Africa, and we dont know if well ever get access to the current suite of vaccines produced elsewhere, she says.

The decision to move forward, she insists, has to be left to South African scientists, regulators, and ethics committees. Its incredibly patronizing for people to determine what science is good or bad for other countries, she says. Everyone knows about Phambili and STEP, and the scientists understand that theres an important need to be cautious.

Gray, who has co-authored papers about HIV vaccines with Corey and the other three authors of the Lancet correspondence, says there are no easy answers. What if this vaccine is the most effective vaccine? she asks. If this works out to be an important vaccine, well have some experience with it.

See more here:

Could certain COVID-19 vaccines leave people more vulnerable to the AIDS virus? - Science Magazine

Live Covid-19 Updates: The Latest Globally – The New York Times

Heres what you need to know:New Jersey Gov. Phil Murphy is advising residents against non-essential out-of-state travel.Credit...Noah K. Murray/Associated Press

Coronavirus cases in New Jersey, an early epicenter of the pandemic, are on the rise again, doubling over the last month to an average of more than 900 new positive tests a day, a worrisome reversal of fortune for a state that had driven transmission rates to some of the nations lowest levels.

After an outbreak several weeks ago in a heavily Orthodox Jewish town near the Jersey Shore, cases are now rising in counties across the state, driven, officials say, by indoor gatherings.

The states health commissioner has said there are signs of widespread community spread for the first time since New Jersey successfully slowed the spread of a virus that has claimed the lives of more than 16,000 residents. A small, densely packed state, New Jersey has the highest virus fatality rate in the country.

Gov. Philip D. Murphy said Monday that residents should refrain from all but necessary out-of-state travel.

The numbers are up, Mr. Murphy said. Theyre up up and down the state.

Under a quarantine policy adopted by New Jersey, New York and Connecticut, New Jersey now exceeds the threshold an average of 10 cases for every 100,000 residents for seven days used to determine which states should be included in the travel advisory. Thirty-eight other states are on the list.

The uptick comes as other parts of the Northeast and states across the country are confronting similar surges of infections and hospitalizations as the pandemic stretches into its eighth month, with a death toll that now exceeds 219,000, according to a New York Times database.

Mr. Murphy, who has been conservative in allowing the state to reopen, said he would consider targeted shutdowns to curb the spread, as Connecticut and New York have done, but he suggested that would not cure the problem.

As the coronavirus pandemic erupted this spring, two professors at Stanford University Dr. Jay Bhattacharya and Dr. Scott W. Altas bonded over a shared concern that lockdowns were creating economic and societal devastation.

Now Dr. Atlas is President Trumps science adviser, a powerful force inside the White House. And Dr. Bhattacharya is one of three authors of the so-called Great Barrington Declaration, a scientific treatise that calls for allowing the coronavirus to spread in order to achieve herd immunity the point at which enough people have been infected to stall transmission of the pathogen.

The Centers for Disease Control and Prevention and leading experts have recently concluded, using different scientific methods, that as many as 90 percent of Americans are still vulnerable to infection.

While Dr. Atlas and administration officials have denied advocating the herd immunity approach, they have praised the ideas in the declaration. The message is aligned with Mr. Trumps vocal opposition to lockdowns on the campaign trail, even as the country grapples with renewed surges of the virus.

The central proposition is that to contain the coronavirus, people who are not vulnerable should immediately be allowed to resume life as normal while those at high risk are protected from infection.

Under that scenario, younger Americans should return to workplaces, schools, shops and restaurants, while older Americans would remain cloistered from the virus as it spreads, recipients of such services as grocery deliveries and medical care.

It argues that eventually so many younger Americans will have been exposed, and presumably will have developed some immunity, that the virus will not be able to maintain its hold on the communities.

The manifesto does not contain details on how the strategy would work in practice, nor do its authors have expertise in implementing public health programs. Dr. Anthony S. Fauci, the governments top infectious disease expert, dismissed the declaration as unscientific, dangerous and total nonsense, as well as unethical, particularly for multigenerational families and communities of color.

The idea has alarmed and angered other public health researchers. On Wednesday, about 80 published a manifesto of their own, the John Snow Memorandum (named after a legendary epidemiologist), saying that this approach would endanger one-third of the U.S. population who have conditions that put them at high risk from severe Covid-19, and result in perhaps a half-million deaths.

I think its wrong, I think its unsafe, I think it invites people to act in ways that have the potential to do an enormous amount of harm, said Dr. Rochelle Walensky, an infectious disease expert at Harvard University and one of the signatories to the Snow memo. You dont roll out disease you roll out vaccination.

President Trump attacked Dr. Anthony S. Fauci, the governments top infectious disease expert, in a conference call on Monday with campaign aides, calling the doctor a disaster and saying, People are tired of hearing Fauci and these idiots, all these idiots who got it wrong.

He continued his criticism of Dr. Fauci, the overwhelmingly popular director of the National Institute of Allergy and Infectious Diseases, after landing in Arizona for the first of two scheduled rallies in the state, which is experiencing a rise in coronavirus cases.

Speaking to reporters after deplaning Air Force One, Mr. Trump called Dr. Fauci a very nice man but complained that he loves being on television and has made a lot of bad calls. Asked why he didnt fire Dr. Fauci, Mr. Trump said, Hes been there for about 350 years. I dont want to hurt him.

At a campaign rally on Monday in Arizona, where polls show that the president is trailing Mr. Biden, Mr. Trump also faulted the news media for excessive coverage of the coronavirus.

Theyre getting tired of the pandemic, arent they? Mr. Trump said in Prescott, in central Arizona. You turn on CNN. Thats all they cover. Covid, Covid, pandemic, Covid, Covid.

The attack on Dr. Fauci comes as the United States has seen more coronavirus cases over 8 million and more deaths nearly 220,000 than any other nation in the world. The presidents advisers have tried to get him to lay off the infectious diseases specialist, who remains popular.

Dr. Fauci pushed back against complaints that he had flip-flopped over the use of masks, saying that admitting a mistake after examining further data shows honesty.

The conflict began Sunday night on the CBS News program 60 Minutes, when Dr. Fauci said it was absolutely no surprise that President Trump got sick with the coronavirus, given his lax attitude toward social distancing guidance.

I was worried that he was going to get sick when I saw him in a completely precarious situation: crowded, no separation between people and almost nobody wearing a mask, Dr. Fauci said in the CBS interview. He was referring to an event at the White House in September to announce the nomination of Amy Coney Barrett for the Supreme Court.

When I saw that on TV, I said, Oh, my goodness, nothing good can come out of that thats got to be a problem, Dr. Fauci said. Sure enough, it turned out to be a super-spreader event.

Numerous people who attended the event later tested positive for the coronavirus, including the president.

Dr. Fauci, who has often been at odds with the president, sharpened his stance against an ad run by Mr. Trumps re-election campaign that appeared to show the doctor praising the presidents handling of the coronavirus. Dr. Fauci said his words were taken out of context, and that their use in the ad was inappropriate because he never endorses candidates.

I got really ticked off, he said.

Mr. Trumps attacks on Dr. Fauci led Senator Lamar Alexander of Tennessee to become the latest Republican to distance himself from the president. Dr. Fauci is one of our countrys most distinguished public servants, said Mr. Alexander, who is retiring this year. He has served six presidents, starting with Ronald Reagan. If more Americans paid attention to his advice, wed have fewer cases of Covid-19, and it would be safer to go back to school and back to work and out to eat.

The National Academy of Medicine honored Dr. Fauci on Monday with the academys first Presidential Citation for Exemplary Leadership, citing his distinguished service as a trusted adviser to six U.S. presidents during public health crises and steady leadership during the Covid-19 pandemic.

In his acceptance speech, Dr. Fauci said that to inspire public trust and confidence in vaccines, people needed to hear consistent messages from the government, not conflicting ones.

A judge in Wisconsin, the site of the one of the worst outbreaks of a resurgent coronavirus, has upheld an executive order by Gov. Tony Evers that limits public gatherings to 25 percent of a building or rooms capacity.

This critically important ruling will help us prevent the spread of this virus by restoring limits on public gatherings, said the governors office in a statement. This crisis is urgent. Wisconsinites, stay home.

The ruling means in rural Wisconsin, many restaurants, taverns, and supper clubs with no maximum capacity set by local authorities will be limited to ten patrons dining-in at a time, according to the Tavern League of Wisconsin, which requested a temporary injunction on Emergency Order #3 from the circuit court judge.

The state has reported more than 22,500 new coronavirus cases in the last week, according to a New York Times database, putting Wisconsin behind only North Dakota, South Dakota and Montana in terms of new infections per capita.

The Tavern League, which sued for relief against the executive order, represents about 5,000 small businesses, according to Scott Stenger, who heads the leagues government affairs outreach. We dont take suing anybody lightly, let alone the governor of our state, Mr. Stenger said. Its not something wed do before.

Mr. Stenger said the league had not been consulted ahead of time about the emergency order, and did not have an opportunity to help craft regulations that might better help eateries and bars across the rural parts of the state stay open while still taking precautions to protect their customers.

The issue is especially acute in rural areas of Wisconsin, where there are often no set capacity limits for restaurants and taverns. By default, those businesses will be limited to ten patrons.

Without economic assistance from the state, or from Congress, Mr. Stenger said that more of his members will likely go out of business.

California will have its own independent panel of experts review any federally approved coronavirus vaccines before they are administered to residents, Gov. Gavin Newsom said on Monday.

Of course we wont take anyones word for it, he said in a news briefing. He emphasized that the second set of eyes on potential vaccines is part of Californias broader efforts to make sure that vaccines get equitably distributed to communities that are most vulnerable.

While Mr. Newsom acknowledged that the vaccine approval process has been politicized, he said, It doesnt matter who the next president is, were going to maintain our vigilance.

The announcement came after Gov. Andrew M. Cuomo of New York said that his state would also review vaccines approved by the federal government although Mr. Cuomo tied the move to doubts raised when President Trump suggested that he would reject tougher F.D.A. guidelines. Frankly, Im not going to trust the federal governments opinion, Mr. Cuomo said in late September.

On Sunday, Mr. Cuomo, as head of the bipartisan National Governors Association, posed additional questions about how the Trump administration will ensure that states are able to get and distribute vaccines.

Mr. Newsom said that his state is working with the federal government on its vaccination plans, but that experts from Californias prestigious academic and health care institutions are helping to figure out expected logistical challenges. They include where to store vaccines that must be kept cold, how to notify people about when to get their second shots and how to guarantee that rural communities have access to vaccines.

Mr. Newsom cautioned against being overly exuberant about the prospect of widespread vaccination; he said that wont happen until next year. This vaccine will move at the speed of trust, he said.

Californias new case rates have stayed relatively low, even as the state has expanded testing and gradually lifted restrictions on businesses. Still, the governor implored residents not to let their guard down as the holidays approach.

Countries across Europe announced new restrictions on Monday in an effort to halt a strong second wave of the virus, as the global tally of cases passed 40 million. Cases have been detected in nearly every country around the world, and at least 1.1 million people have died.

Officials are desperate to avoid a second economically damaging blanket lockdown, and are instead seeking to tighten restrictions in a more precise fashion. Heres the latest.

Ireland will be imposing its highest level of restrictions starting on Wednesday night, Prime Minister Michael Martin announced on Monday. Nonessential businesses will be mandated to close, restaurants and pubs will be limited to takeout, and people will not be allowed to travel more than five kilometers (three miles) from their homes. Schools and construction sites will remain open, however, the public broadcaster RTE reported. The restrictions, which will remain in effect for six weeks, come after the country set new daily case records four times in the past week. If we pull together over the next six weeks we will be able to celebrate Christmas in a meaningful way, Mr. Martin said.

In Spain, the region of Navarre announced on Monday the countrys most drastic regional measures yet to contain the second wave. As of Thursday, Navarre will stop its residents from leaving their region except for work or emergency reasons. It will also close for 15 days its bars and restaurants, and force all shops, sports venues and other establishments to close by 9 p.m. The measures come after Navarre reported an average of 945 cases per 100,000 inhabitants over the past 14 days, three times the national average.

Austria, which reported 1,121 daily cases of the virus on Monday, announced new limits on the number of people who could meet privately starting Friday: six indoors and 12 outdoors. The country has reported nearly 10,000 cases in the past week, more than at any time in March, when the government imposed a nationwide lockdown. The restrictions were lifted over the summer as numbers dropped and the country sought to attract tourists, an important source of income for the alpine nation.

In Italy, Prime Minister Giuseppe Conte announced that mayors will have the power to close streets or squares where people tend to gather after 9 p.m., while restaurants, bars and pubs will be allowed to serve seated customers up to six per table until midnight. Drinking outside of restaurants or bars will be permitted only until 6 p.m., and gaming and betting halls will close at 9 p.m. Italy has so far fared better than its European counterparts, but infections have been rising in recent weeks, with a record 11,705 new cases reported on Sunday.

France imposed a nightly curfew in nine cities, including Paris, over the weekend, and asked people throughout the country to limit gatherings to six people to halt an alarming spike in cases. On Monday, the office of President Emmanuel Macron announced that the first lady, Brigitte Macron, was in quarantine after being exposed to someone who had tested positive. Ms. Macron has not shown any symptoms, the office said in a statement.

Slovenias government declared a 30-day state of emergency after cases of the virus more than doubled in the past week, Reuters reported. The government will ban movement between regions that have been most affected by the pandemic and introduce a nightly curfew beginning at 9 p.m. starting Monday, Interior Minister Ales Hojs said at a news conference. Mr. Hojs said that all public and religious events would be banned, and that the number of people allowed to gather would be reduced to six from 10. Slovenia has reported 4,845 coronavirus cases in the past week, a spike from 2,255 cases the week before.

Britain has reported an average of nearly 17,000 new cases a day over the past week, according to a New York Times database, with almost a thousand new daily cases in Wales.

Wales will enter a national lockdown starting Friday night, the countrys first minister, Mark Drakeford, announced on Monday. The firebreak lockdown, which will last until Nov. 9, will require residents to remain at home and force pubs, restaurants and nonessential shops to close. Mr. Drakeford said there are no easy choices in front of us and called the lockdown our best chance of regaining control of the virus and avoiding strain on the National Health Service.

About 2.3 million of the 3.1 million people in Wales were already living under local lockdowns. and the country has effectively shut its borders to travel from other parts of Britain.

And officials in Bucharest, the Romanian capital, announced that schools, theaters and indoor dining will be closed for at least two weeks, and that masks will become mandatory in all public spaces. The city reported on Sunday that the virus rate over the previous 14 days had exceeded three cases per 1,000 residents, a red line for imposing stricter rules. After keeping the virus largely in check during the initial months of the pandemic, Romania has seen cases triple over the past month. While the schools will switch to online learning, there is deep concern that many students lack tablets and other necessary materials.

As the Trump administration has pressed publicly for top-speed development and approval of a coronavirus vaccine, while researchers and public health experts warned of the dangers of rushing the process, the idea of getting the vaccine as soon as it is available is losing appeal for many Americans, especially Black Americans, recent surveys show.

In a STAT-Harris poll of about 2,000 people, conducted Oct. 7-10 and published Monday, 58 percent of respondents said they would get vaccinated right away, down from 69 percent who said the same in August.

The decline was twice as steep among Black respondents: just 43 percent said in October that they would get the vaccine, down from 65 percent in August.

Rob Jekielek, managing director of The Harris Poll, which has been asking the question throughout the pandemic, said two news events appeared to have played a role in the falloff: the back-and-forth between the Food and Drug Administration and the White House over vaccine guidelines, and President Trumps Covid-19 diagnosis and treatment.

The politicization of the process is having a huge negative effect, especially with Black Americans, he said in an interview.

Pew Research Center polls that framed a question on the issue somewhat differently also found growing hesitation over a vaccine: About 51 percent of adult respondents said in September that they would definitely or probably get a vaccine if one were available, down from 72 percent who said the same in May. The surveys included more than 10,000 respondents and had a margin of sampling error of plus or minus 1.6 percentage points.

Its pretty clear the public is concerned about the pace of the vaccine approval process and have outstanding questions about safety, said Alec Tyson, associate director of Pew Research.

Polls conducted for CNN by the market research firm SSRS asked, If a vaccine to prevent coronavirus infection were widely available at a low cost, would you, personally, try to get that vaccine, or not? Sixty-six percent of respondents said yes in May; just 51 percent did in October. The polls margin of error was plus or minus 3.3 percentage points.

And in an ABC News/Ipsos poll last month, 64 percent of respondents said they would take a safe and effective coronavirus vaccine, down from 74 percent in May. Those polls had a margin of error of 4.9 points.

For months, as New York City struggled to start part-time, in-person classes, fear grew that its 1,800 public schools would become vectors of coronavirus infection.

But nearly three weeks into the in-person school year, early data from the citys first effort at targeted testing has shown the opposite: a surprisingly small number of positive test results.

Out of 15,111 staff members and students tested randomly by the school system in the first week of its testing regimen, the city has gotten back results for 10,676. There were only 18 positives: 13 staff members and five students.

And when officials put mobile testing units at schools near Brooklyn and Queens neighborhoods that have had new outbreaks, only four positive cases turned up out of more than 3,300 tests conducted since the last week of September.

New York City is facing fears of a second wave of the virus brought on by localized spikes in Brooklyn and Queens, which have required new shutdown restrictions that included the closure of more than 120 public schools as a precaution.

On Monday, Mayor Bill de Blasio said that city continued to see a leveling off in those areas and officials had seen particular progress in central Queens, the mayor said. But he did not provide data for those areas.

Across the city, the seven-day average positivity rate was at 1.62 percent, the mayor said. When he first announced an uptick in cases about three weeks ago, the positivity rate was 1.38 percent.

Shortly afterward on Monday, Gov. Andrew M. Cuomo said that data in different hot spot areas across the state where he had imposed restrictions by zones would continue to be reviewed, and that the state would announce changes to the zones on Wednesday. Zone sizes could be made larger or smaller, he said, adding that we have total flexibility in these zones.

Statewide, the daily positivity rate was 1.21 percent, he said, while the red zones, which have the most severe restrictions in place, had a positivity rate of 3.31 percent. Hospitalizations statewide, which have been steadily increasing in recent weeks, are 934.

But for now, at least, New York Citys sprawling system of public schools, the nations largest, is an unexpected bright spot as the city tries to recover from a pandemic that has killed more than 20,000 people and severely weakened its economy.

In September, New York became the first big urban district to reopen schools for in-person learning.

Roughly half of the citys students have opted for hybrid learning, where they are in the building some days, but not others. The approach has enabled the city to keep class sizes small.

Over the last two weeks, Catholic leaders in New York have voiced their deep disapproval with Gov. Andrew M. Cuomo over his decision to sharply limit attendance at houses of worship in areas that are seeing a surge of new coronavirus cases.

The governors decision was largely aimed at trying to rein in congregants in Orthodox Jewish synagogues in New York City and in Orange and Rockland Counties, where some members have flouted social distancing and mask regulations.

But it also affected other houses of worship, including about two dozen parishes in the diocese covering Queens and Brooklyn, where Catholic officials have sued Mr. Cuomo in federal court, insisting that they have been abiding by the rules and should not be punished.

Weve gone above and beyond what they have recommended and mandated, said Dennis Poust, a spokesman for the New York State Catholic Conference. So if theres an animus, its coming from his end, not our end.

Leaders of the Diocese of Brooklyn and the Archdiocese of New York have also criticized the restrictions, which have closed nonessential businesses and limited occupancy in so-called red zones to 25 percent of building capacity or a mere 10 people, whichever is lower.

To have all of the steps weve taken be ignored, and to face the prospect of indefinite unreasonable restrictions placed upon our churches is just not fair! Cardinal Timothy M. Dolan wrote in a blog post last week. Why are churches being singled out? Why especially are those houses of worship that have been exemplary, strict and successful in heeding all warnings, being shut down again?

GLOBAL ROUNDUP

Polands deputy prime minister and de facto leader, Jaroslaw Kaczynski, is going into quarantine after learning that he had been in contact with someone infected with the coronavirus, a government spokesman said, adding that Mr. Kaczynski, who is 71, feels well and will continue performing his duties from home.

Mr. Kaczynski did not wear a mask when he handed out an award at a ceremony last week, and briefly took off his mask when he was sworn in as deputy prime minister on Oct. 6.

Poland largely resisted the first wave of the pandemic with an early lockdown that began in March. But after it reopened all its schools for in-person instruction in early September, case counts started climbing, and the country is now battling a major surge of infections and hospitalizations. Poland has reported 49,950 new cases in the last seven days, according to a New York Times database, and 175,766 in all, with more than 3,500 Covid-19-related deaths.

With hospital beds filling up, there is particular concern about the damage that the virus could sow in Poland, which has a relatively weak health care system and one of the lowest ratios of doctors and nurses to residents in the European Union.

To deal with the surge, the government is transforming the national stadium in Warsaw into a field hospital. The health minister, Adam Niedzielski, said on Monday that temporary Covid-19 hospitals would also be set up in other major cities, and that he was in discussions with private hospitals about making more beds available. Mr. Niedzielski warned that if the virus continued to spread at its current pace, the country could soon be facing as many as 20,000 new cases a day.

In other developments around the world:

Restrictions on nonessential travel between the United States, Canada and Mexico will be extended until Nov. 21, Chad Wolf, the acting secretary of Homeland Security, announced on Monday. We are working closely with Mexico & Canada to identify safe criteria to ease the restrictions in the future & support our border communities, Mr. Wolf wrote on Twitter. In the past seven days, Canada has reported 16,284 cases, which works out to 44 per 100,000 people; Mexico, 33,724 cases, or 27 per 100,000; and the U.S., 396,305 cases, or 119 per 100,000.

Officials in Melbourne, Australia, announced some easing of one of the worlds strictest lockdowns, allowing residents to travel up to 25 kilometers from their homes and up to 10 people from two households to socialize outdoors. Dan Andrews, the premier of the state of Victoria, drew a contrast between the situation there and in Britain, where there have been fewer restrictions despite a surge in cases. Back in August and at our peak, we reported 725 daily cases. At the same time, the U.K. recorded 891, he said in a statement. Today, as Victoria records two new cases, the U.K. hit 16,171. And as we continue easing our restrictions, they are being forced to increase theirs.

Twenty-five crew members aboard a livestock carrier docked at a port in Western Australia have tested positive for the coronavirus. The ship, the Al Messilah, has 52 crew members, and the authorities warned that further positive test results were possible.

See the original post here:

Live Covid-19 Updates: The Latest Globally - The New York Times

Covid-19 testing lags as cases increase across the United States – NBC News

While critics of wide scale testing, including President Donald Trump have asserted that surges in cases can be explained by increased testing, health experts say that a jump in confirmed cases is usually caused by more people getting sick.

And those experts, who have long urged that testing is a critical tool in the fight against the pandemic, say that the lack of aggressive and consistent testing has contributed to the viruss spread.

If we really wanted to get things under control, frequent testing of almost everybody would be one way to do it and were, of course, nowhere near that, Marc Lipsitch, a professor of epidemiology at the Harvard T.H. Chan School of Public Health, said. Were doing infrequent testing of almost no one.

There are several reasons why states arent conducting enough tests, experts say, including the diminished fear of the virus on the part of some people, who are increasingly getting tired of wearing masks, practicing social distancing and seeking Covid-19 tests.

The initial level of fear is not at the level that it was, said Melissa Nolan, an assistant professor of epidemiology at the University of South Carolina, which has resorted to offering students T-shirts and raffles as an incentive for testing. Testing fatigue and mask-wearing fatigue is real.

Without widespread testing, cities and states dont have the ability to track who has the virus and who is at risk of getting it, experts say.

There's still a dearth of testing, Lipsitch said, pointing to colleges and sports as areas that are able to operate through the pandemic due to aggressive testing policies. In places with higher resources, such as universities, you can actually figure out where people are getting exposed and infected.

Nigel Chiwaya is a deputy data editor for NBC News.

Joe Murphy is a data editor at NBC News Digital.

See the original post here:

Covid-19 testing lags as cases increase across the United States - NBC News

A Doctor Weighs In As Families Discuss Thanksgiving Plans And COVID-19 Risk – Here And Now

Many families are starting to have tough conversations about whether or not to gather together for Thanksgiving amid the coronavirus pandemic.

Thanksgiving weekend is usually one of the busiest travel holidays in the U.S. But this year, Dr. Anthony Fauci is urging families to scale back their holiday plans.

It is unfortunate because thats such a sacred part of American tradition the family gathering around Thanksgiving, Fauci told CBS Evening News last week. But that is a risk.

Dr. Carlos del Rio, a professor of global health and epidemiology at Emory University in Atlanta, says transmission between family members is high because we tend to be maskless and congregate in indoor common spaces.

Earlier this month, Dr. Deborah Birx warned that COVID-19 transmission is different than in the spring as people move indoors, humidity drops and respiratory droplets stay in the air longer.

Birx added that in Utah, public health officials traced 80% of coronavirus infections to small gatherings where people let down their guard, The CT Mirror reports.

Seeing family members outside of your bubble may appear safe because they are people you are familiar with, he says. But that doesnt mean you should get too comfortable, he says.

People are going to be getting together with people that they feel comfortable with when the reality is there could be transmission happening, he says.

And even if you all live under one roof, COVID-19 transmission is still possible. For example, del Rio says he and his wife live together but work at different hospitals, thus risk of infection persists in their bubble.

For travel, flying may be pretty safe, he says, because of the cleaning measures airlines are taking. Many airlines are filtering the air and making masks mandatory, he says.

What may be a little more challenging is the pre-boarding process, he says, such as taking a taxi or ride-share to the airport, security lines and just being in the airport.

If you plan to gather for the holidays, he says to keep it to less than 10 people and try to make sure everyone is healthy. Its okay to share food, he says, but keep social distancing in effect while eating. Avoid hugging and being in close proximity, he advises.

And if you can, get a coronavirus test beforehand, he says.

If you can get people tested, I think that's useful, he says. But again, remember, a test helps you identify who's infected, not necessarily who's not.

The Centers for Disease Control and Prevention recently released guidance on holiday gatherings and what Americans need to do to stay safe while traveling, hosting or attending a Thanksgiving get-together.

Del Rio says the CDCs precautions, such as correctly wearing a face mask and social distancing, during travel and gathering can be taken to lessen the risk.

Ashley Lockeproduced and edited this interview for broadcast withTodd Mundt.Serena McMahonadapted it for the web.

See the article here:

A Doctor Weighs In As Families Discuss Thanksgiving Plans And COVID-19 Risk - Here And Now

For Trump, Covid-19 therapeutics are the new vaccines – STAT – STAT

WASHINGTON In North Carolina last week, President Trump told voters at a campaign rally not to fear Covid-19 because theyd soon have access to a coronavirus cure. The experimental treatment, he told supporters the next day in Iowa, made him feel like Superman. In Florida, he told seniors theyd soon have access, for free, to the antibody therapy hed received during his own bout with the virus two weeks before.

Its a significant shift. Trump campaigned for months on the dubious pledge that a vaccine would be available before a very special date, an open nod to Election Day. But as its become clear drug companies wont help Trump deliver on a key campaign promise by Nov. 3, hes largely dropped the aggressive vaccine rhetoric. Instead, hes begun to campaign on equally lofty boasts of a Covid-19 cure-all even though the treatments remain unproven and unavailable to the general public.

We have to get em approved, and I want to get em to the hospitals where people are feeling badly, Trump said in a recent video. Thats much more important to me than the vaccine.

advertisement

Trumps pivot to touting therapeutics underscores his desperation to claim that his government is making significant progress in combating the pandemic. And it is an attempt, too, to turn his own Covid-19 diagnosis from a weakness into a strength, bolstering the dangerous arguments that Americans shouldnt fear the virus or let it dominate their lives.

Clearly, theres been a shift in what the President talks about, said Walid Gellad, a physician and health policy professor at the University of Pittsburgh. That may just be a factor of the personal experience, although clearly its also related to the reality of the vaccine. I dont know which of those it is.

advertisement

Trumps latest comments have stoked additional fear among public health experts and scientists that Americans will take the presidents advice and largely ignore the pandemic unfolding around them. Even as Trump campaigns regularly in front of thousands of mostly unmasked supporters, case rates are spiking across the country. Over 700 Americans still die of Covid-19 each day.

Even amid the spikes, Trump has argued that Americans should return to business as usual, given the existence of the experimental therapies.

Public health experts are still urging people to continue to follow social distancing guidelines and to wear masks in public. With the weather growing colder, Americans spending more time indoors, and the holiday travel season approaching, experts including Tony Fauci, the governments leading infectious disease researcher, warn that failure to adhere to basic public health guidelines could have deadly consequences.

Trump has fixated particular on a treatment hes referred to as Regeneron in fact, an as-yet-unnamed cocktail of antibodies being developed by Regeneron, a New York drug manufacturer. Trumps effusiveness even led the Lincoln Project, a coalition of Republicans opposed to his re-election bid, to publish a fake commercial mocking Trump for hawking an unproven cure.

Youve got to open up your businesses, open up your schools, Trump said at a campaign rally in North Carolina on Thursday. We have incredible therapeutics, we have incredible drugs, we have, in my opinion, a cure. Because I took something, Regeneron, it was highly sophisticated stuff. The antibodies, and Eli Lilly makes an incredible drug.

Its unclear whether Americans are taking his words to heart. Trumps message, however, is clearly out of step with reality, given skyrocketing case rates and a corresponding increase in Covid-19 hospitalizations.

I have not seen any polling on whether this latest fusillade of claims regarding that great drug Regeneron has convinced anyone that there are cures out there, period, let alone readily available ones for the population, said Peter Bach, a doctor and health policy researcher at Memorial Sloan-Kettering Cancer Center in New York. I cant remember how many times the boy had to cry wolf before he was ignored, but I am sure the president has exceeded that number by now, probably by severalfold.

Trumps tone regarding new Covid-19 therapies has exceeded even his prior effusiveness regarding vaccines: Since his release, Trump has attempted to convince Americans theyll soon have access to the same level of treatment he received at Walter Reed.

We have Regeneron, we have a very similar drug from Eli Lilly, and theyre coming out, and were trying to get them on an emergency basis, Trump said in a video posted to Twitter on Oct. 7, in which he said contracting coronavirus may have been a blessing from God. Weve authorized it, Ive authorized it, and if youre in the hospital and youre feeling really bad, I think were going to work it so that you get em, and youre going to get em free.

The promises ignore key context: The president is among a small handful of people around the world whove received access to the Regeneron antibody therapy outside the setting of a clinical trial. The Food and Drug Administration has not yet issued an emergency use authorization for either therapy in fact, one trial testing Eli Lillys antibody treatment for hospitalized patients was recently paused following a potential safety concern.

As with other once-touted Covid-19 treatments, however, Gellad said the presidents enthusiasm could do more harm than good, especially when it comes to the publics perception of the FDA. Trump has already telegraphed that his administration will soon issue emergency authorizations for both the Regeneron and Eli Lilly antibody therapies. If the FDA does so, it might appear that Trumps rhetoric influenced the decision even if the agencys scientists didnt factor in the presidents eagerness. The scenario has already played out twice in 2020, Gellad said: First over the malaria drug hydroxychloroquine and again over the use of blood plasma from recovered Covid-19 patients.

The perception, and the reality, is that theres a lot of political interference, whether its addressing hydroxychloroquine, plasma, antibodies, or vaccines, Gellad said. In reality, all of these drugs might fit the criteria for what FDA would have done probably anyway.

Read more here:

For Trump, Covid-19 therapeutics are the new vaccines - STAT - STAT

Trends in Overall and Non-COVID-19 Hospital Admissions – Kaiser Family Foundation

Approximately seven months after the coronavirus sparked social distancing measures and concerns about hospital capacity, new medical records data help shed light on the magnitude of the drop in hospital admissions and the more recent rebound in hospitalizations. These new data provide additional information to help assess the economic impact of the COVID-19 pandemic on hospitals and insurers and also provide more information to help assess the extent to which people are still delaying or forgoing care. We analyze trends in total hospital admissions and then separately analyze non-COVID-19 admissions by patient sex, age, and region. We calculate actual admissions as a share of total predicted admissions in 2020 based on trends from past years. Key findings include:

This new analysis is based on electronic medical record (EMR) data from Epic Health Research Network (EHRN) and includes all inpatient hospital admission volume from Dec 31, 2017 to August 8, 2020, involving patients who either were discharged or died, as of September 13, 2020. Data are aggregated weekly and pooled from 27 health care organizations in the United States, representing 162 hospitals that span 21 states and cover 22 million patients. These states represent 67.0% of COVID-19 cases as of September 23, 2020 and also represent 66.5% of the U.S. population. Predicted volume was calculated using historical data from Dec 31, 2017 to Jan 25, 2020. COVID-19 admissions were identified as admissions with either a documented COVID-19 diagnosis (U07.01) or other respiratory diagnosis involving a patient who either had tested positive or presumptive positive for COVID-19 or received a COVID-19 diagnosis within 14 days of the admission.

Several recent studies show that, beginning in March 2020, social distancing measures, concerns over hospital capacity, and fears of contracting COVID-19 led to sharp declines in health care spending. Across all health care services, not including pharmaceutical drugs, expenditures were down 38% in April 2020, compared to April 2019. More recently, overall spending on health care has started to rebound and, by June, spending was only 10% lower than the previous year.

An earlier EHRN analysis of EMR data found similar patterns for emergency department visits for acute myocardial infarctions and stroke, with sharp declines followed by increases that brought those emergency department visits roughly back to expected rates. In late March to early April, the incidence of these conditions as reported in hospital emergency department records was down by 45% for AMIs and 38% for strokes.By the end of May, the weekly incidence of acute myocardial infarction admissions had returned to approximately 92% of the pre-pandemic trend (prior to March 13, 2020). Similarly, the incidence of emergency department visits for stroke returned to approximately 87% of the historical trend. Analysis of EMR data for breast, cervical, and colon cancer screenings showed an even sharper decline beginning in early March followed by an increase in screenings; even so, screening rates have remained far below 2019 levels. By mid-June, weekly volumes for these cancer type screenings remained roughly 30-35% lower than their pre-COVID-19 levels.

A recent analysis of outpatient office visits published by the Commonwealth Fund found that visits fell nearly 60% by early April and then increased, plateauing as of July at 10% below the pre-pandemic baseline. Another analysis of outpatient visits that included data through May 15, 2020 found that non-COVID-19 outpatient visits dropped by almost 40 percent by mid-April and then started to increase by mid-April. An analysis of data from 18 states that was published by the Health Care Cost Institute found similar patterns for childhood vaccinations and cancer screenings. A study published in September in Health Affairs used data from a national medical group specializing in hospital medicine to analyze hospital admissions. That study reported similar patterns to ourswith all medical admissions in April having declined by 34.1%, and by June/July they were 8.3% lower relative to baseline volume.

Our analysis of EMR data shows a precipitous drop in hospital admissions starting the week of March 14, 2020, falling to a low of roughly 70% of predicted admissions by the week of April 11 (Figure 1)just four weeks after the March 13, 2020 national emergency proclamation. Admissions gradually began to increase soon after that date and, by July 11, admissions were back to approximately 95% of their predicted level. More recently, total admissions dipped slightly and are now at about 90% of predicted levels.

The lost admissions between March 8 and August 8, 2020 account for 6.9% of the total number of admissions predicted during the 2020 calendar year. If the number of admissions remains at about 90% of predicted admissions (as they were on August 8) through the end of the year, total admissions will be 10.5% below predicted volume for the entire year. If there are new restrictions on non-emergency procedures in the latter part of 2020, the share of lost admissions likely will be higher.

Implications for hospital finances

This drop in admissions was not something that hospitals could have anticipated at the beginning of the year and suggests revenue losses that may be difficult for some hospitals to weather. Hospitals financial strength differs widely. One recent study found that the median hospital had enough cash on hand to pay itsoperating expenses for 53 days in 2018, but the 25thpercentile hospital only had enough cash on hand for 8 days. Smaller hospitals and rural hospitals are among those most likely to face financial challenges in the wake of revenue loss related to COVID-19. These hospitals may be more likely to close or merge if they do not have the financial resources to make up for declines in revenue caused by the declines in admissions shown in our data.

Hospitals and other health care providers have qualified for various types of federal assistance during the coronavirus pandemic. However, much of this money was not targeted to safety net hospitals operating on narrow margins. Most notably, hospitals and other Medicare and Medicaid providers received grants from the $175 billion provider relief fund that is being distributed by the Department of Health and Human Services (HHS). Hospitals qualified for grants that were the equivalent to a minimum of 2% of revenue and on average received grants that amounted to about 5.6% of revenue. Hospitals that qualified for additional grants either qualified by seeing a high number of COVID-19 inpatients by June 10 or were childrens hospitals, rural hospitals and/or safety net hospitals. About $30 billion remains available for future grant allocations as of October 8, 2020. It is unclear how the Department of Health and Human Services will allocate that money. How declines in admissions translates into lost hospital revenue depends on the type of admissions that were missed and which insurers paid for those admissions. Private insurers typically reimburse at higher rates than Medicare or Medicaid, and reimbursement widely varies by type of admission.

Hospitals and other providers that participate in traditional Medicare were also eligible for loans through the Medicare Accelerated and Advance Payment Programs, which are designed to help hospitals facing cash flow disruptions during an emergency. About 80% of the $100 billion in loans went to hospitals. Repayment for the loans was originally set to begin in August, but Congress later delayed when repayments would begin and extended the period for repayment.

Hospitals are also receiving a 20% increase in inpatient reimbursement for COVID-19 patients during the current public health emergency. The Congressional Budget Office estimated that this change will increase Medicare spending by about $3 billion. Hospitals may also be eligible for loans being distributed by the Treasury department, the Federal Reserve, and Small Business Administration.

Implications for insurer finances

Health insurers, in contrast, may be benefiting financially from this decline in hospital admissions. Many insurers have been reporting large profits despite voluntarily eliminating cost sharing for patients with COVID-19. The Affordable Care Acts (ACA) Medical Loss Ratio limits the share of premiums that insurers can keep for overhead and profit. This means that beneficiaries get a refund check from their insurer if it did not spend a sufficient share of premiums on health care costs for beneficiaries. Using preliminary data reported by insurers to state regulators and compiled by Market Farrah Associates, KFF estimated insurers will be issuing a total of about $2.7 billion in rebates across all markets in 2020nearly doubling the previous record high of $1.4 billion last year.

We used EMR data from EHRN to look specifically at non-COVID-19 admissions by patient sex, age and region. By looking specifically at non-COVID-19 admissions, we can more easily assess declines in the use of health care due to voluntary and mandatory delays in non-emergency care. This analysis does not include specific diagnoses or procedures to assess which types of admissions had the steepest declines. Declines in certain types of admissionssuch as car crashesmay be explained by changes in habits due to the coronavirus pandemic. However, as discussed earlier in this paper, declines in cancer screenings suggest that the overall decline in admissions is also a sign of patients delaying or foregoing preventive care and therefore not starting necessary treatments. Some cancer treatments were also delayed earlier in the pandemic, although those treatments may now have resumed in many cases.

Non-COVID-19 admissions by sex

Non-COVID-19 admissions for both male and female patients dropped to about 60% of predicted admissions in April 2020 and then increased to roughly 85-90% of predicted admissions by the summer (Figure 2). On an absolute level, admissions for female patients remained about 20% higher than for male patients (data not shown). Much of this differential is likely due to womens admissions for childbirth.

Non-COVID-19 admissions by age

We stratified the EHRN admissions data by age to assess trends in non-COVID-19 admissions for patients age 65 and older compared to younger patients. We found that admissions for patients age 65 and older was just 50-55% of predicted levels in April 2020, compared to 65-70% of predicted levels for younger patients (Figure 3). Admissions among patients age 65 and older have not rebounded as quickly as younger patients. Admissions for patients age 65 and older were at roughly 80% of their predicted level in late July and early August, while admissions for patients under age 65 were at approximately 90% of predicted levels during the same time period. Individuals age 65 and older may be more reluctant to schedule non-emergency procedures given that they are at higher risk of serious illness if infected with the coronavirus.

The slower return to normal among older patients may lead to a change in hospitals payer mix. While patients age 65 and older typically have Medicare, the majority of younger patients have private insurance, which typically reimburses at a higher rate than Medicare. If hospitals experience an increase in the share of patients with private insurance, that could help mitigate some of the revenue declines they are likely to see from a drop in overall admissions.

Non-COVID-19 admissions by region

We next examined how non-COVID-19 admission trends differed across geographic regions, using the regions defined by the U.S. Census Bureau. To give a sense of the geographic distribution of our dataset, admissions from the Northeast, Midwest, South, and West regions account for 22%, 37%, 28%, and 13% of overall admissions, respectively. Hospitals in the Northeast experienced the steepest decline in non-COVID-19 admissions, with those admissions decreasing to a low of roughly 50% of predicted admissions the week of April 11 (Figure 4). Admissions in the Northeast have since increased and were at 87% of predicted levels in early August. Hospitals in the Midwest followed a similar pattern but did not experience quite as steep an initial decline in admissions. In the South, where the number of cases increased in some states during the summer, there has been less of a rebound in non-COVID-19 admissions and those admissions were about 82% of predicted levels in early August. Hospitals in the West did not experience as large a decline in admissions, but also have not experienced as large of a rebound. By early August, admissions in the West were at about 83% of predicted levels.

This new analysis from the Epic Health Research Network provides additional insights into patterns of hospital admissions during the COVID-19 pandemic. This adds to a body of research showing the steep decline in admissions in the spring followed by a more recent rebound in admissions. By looking at the patterns in non-COVID-19 admissions, we can see how changes in behavior had a differential impact by region, age, and sex. If overall hospital admissions remain at or above 90% of predicted admissions, hospital revenues may stabilize at a somewhat sustainable level. However, if the coronavirus begins to spread more rapidly later in the fall and non-emergency procedures are once again delayed, it could have serious consequences both for hospitals financial stability and the health of patients.

Tyler Heist, Ph.D., and Sam Butler, M.D., are with the Epic Health Research Network. Karyn Schwartz, M.P.H., is with KFF.

More:

Trends in Overall and Non-COVID-19 Hospital Admissions - Kaiser Family Foundation

Oct. 19: Iowa reports 508 new COVID-19 cases, 275 recoveries and 6 deaths – KTIV

(KTIV) -- There were 508 new, confirmed cases in Iowa from 10 a.m. Sunday to 10 a.m. Monday,according to the state's dashboard.

At 10 a.m. Saturday, health officials reported 107,062 total positive cases across the state, that number rose to 107,570 by 10 a.m. Monday.

The state's website says out of those who have tested positive, 82,056 have recovered. That's an increase of 275 recoveries in the last 24 hours.

The state reported six additional deaths within this time frame, putting the state's death toll to 1,534.

According to the state's latest report, there are 480 Iowans hospitalized due to the virus. Of those hospitalizations, 113 are in the ICU and 45 are on ventilators.

In Iowa, 2,876 new tests were given for a total of901,746 people that have been tested for COVID-19.

As of 9 a.m. Monday, the Siouxland District Health Department reported 49 new COVID-19 cases in Woodbury County. This brings the county's total number of positive cases up to 6,748.

The SDHD has reported no new virus-related deaths, keeping the county's death toll to 89.

To date, 5,022 of the county's cases have recovered.

A total of 64 people are currently hospitalized with COVID-19 in Woodbury County. Forty of those are county residents.

Buena Vista County, where Storm Lake is located, has had one new COVID-19 case, bringing its total cases to 2,195. Of those cases, 1,939 of them have recovered.

So far, the county has had 12 total COVID-19 deaths.

Clay County, where Spencer is located, has reported three new virus cases, with its total now at 482. Of those cases, 294 have recovered

Clay County has confirmed four total virus-related deaths.

State health officials say Dickinson County reported two new cases, bringing their total positive cases to 684. Officials say 479 of those cases have recovered.

Dickinson County has had seven virus-related deaths.

Plymouth County's total positive cases have risen from 1,531 to 1,535 in the last 24 hours. Officials say 1,046 of those cases have recovered.

Plymouth County has reported one additional virus-related death, bringing its death toll up to 25.

As of Oct. 19, the state health department says Sioux County reported four new cases bringing their total to 2,286. Officials say 1,392 of those cases have recovered.

Sioux County has had no additional virus-related deaths, keeping its death toll to 11.

Go here to read the rest:

Oct. 19: Iowa reports 508 new COVID-19 cases, 275 recoveries and 6 deaths - KTIV

One of Michigans largest weekly COVID-19 case increases is in Washtenaw County – MLive.com

ANN ARBOR, MI - Washtenaw County has seen one of the states biggest one-week increases of COVID-19, according to data released on Monday, Oct. 19.

The county went from 200 cases the week of Oct. 4-10 to 433 new cases the week of Oct. 11-17 - the second largest increase in the state. Washtenaw Countys has had an average of 16.83 new cases a day during the past week, per the Harvard Institute.

The countys accelerated rate of COVID-19 transmission has moved it from the yellow zone to orange, based on a metric developed by the Harvard Global Health Initiative to assess coronavirus risk levels.

To date, Washtenaw County has reported 4,229 laboratory confirmed COVID-19 cases, along with 631 probable cases, according to Washtenaw County Health Department data. Thats an increase from the 4,028 the county reported on Friday, Oct.16, including 47 cases that were reported in the past 24 hours.

Eleven percent of cases have resulted in hospitalization, while 119 people from the county have died.

The county had a weekly testing positivity rate of 1.9% as of Oct. 15.

Countywide, 3,484 people have recovered from the coronavirus, which means they are alive 30 days after the start of the virus, per the health department.

Washtenaw Countys increase is similar to neighboring counties like Livingston County, which saw the states third largest increases from week to week, from 85 the week of Oct. 4-10 to 162 new cases the week of Oct. 11-17.

Livingston County reported 68 COVID-19 cases over the weekend. A total of 14 recent COVID-19 cases from the area can be attributed to individuals who attended services at Brighton Assembly of God, after attending services at the church on Oct. 4, Oct. 7 and Oct. 11

Washtenaw Countys daily cases are the closest to Jackson Countys 16.94 new cases a day, with an average of 16.83 new cases a day, per the Harvard Institute.

READ MORE

Monday, Oct. 19, coronavirus data by Michigan county: 70 of 83 counties are trending up

Read the rest here:

One of Michigans largest weekly COVID-19 case increases is in Washtenaw County - MLive.com

Watchdog To Investigate Whether Trump Interfered With Health Agencies’ Covid-19 Response – Forbes

Topline

At the request of Senate Democrats, the government's top watchdog agency will investigate whether the Trump administration's reported interference with agencies handling the Covid-19 outbreak violated federal policies, NBC first reported Monday, following months of reports of tension between President Trump and medical experts.

Dr. Robert Redfield, director of the Centers for Disease Control and Prevention, speaks at a White ... [+] House Coronavirus Task Force briefing on April 22.

The Government Accountability Office agreed to investigate whether the Trump administrations reported interference with the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) violated the agencies scientific credibility and communication policies.

Sen. Elizabeth Warren (D-Mass.), Sen. Gary Peters (D-Mich.) and Sen. Patty Murray, (D-Wash.) on Sept. 8 sent a letter to the Government Accountability Office urging it to investigate if the CDC and FDAs scientific integrity had been undermined and if the policies in place are being implemented based on agency recommendations.

The senators claimed the Trump administration has repeatedly pressured the CDC and FDA to change their messaging to align with Trumps political priorities, according to ABC News which obtained a copy of the letter.

The senators pointed to reports that political appointees at the Department of Health and Human Services (HHS) updated the CDC websites asymptomatic testing guidelines without approval and reports the White House pressured the CDC to downplay the risk of coronavirus transmission in schools to put pressure on schools to physically reopen.

Trump administration officials have repeatedly said the White House has followed the advice of doctors and scientists and denied claims the coronavirus response has been politicized.

Since the start of the pandemic, there have been reports the president and his administration have downplayed the severity of the virus and interfered with the recommendations of scientists and doctors. Earlier this month, 30 senators sent a letter to the HHS Inspector General calling for an investigation into allegations of political interference with public health research and guidelines from the CDC and FDA. They noted the Senate recently introduced the Science and Transparency Over Politics (STOP) Act which would create a Pandemic Response Accountability Committee to investigate political pressure on HHS agencies decisions.

There has been tension between Trump and leading infectious disease expert Dr. Anthony Fauci for months. In an interview with 60 Minutes on Sunday, Fauci said he was absolutely not surprised Trump contracted Covid-19 and said he was worried the president would get sick after he saw him in a completely precarious situation of crowded, no separation between people, and almost nobody wearing a mask. Fauci was referring to the Sept. 26 White House event celebrating the nomination of Judge Amy Coney Barrett to the Supreme Court, which Fauci called a super-spreader event. Fauci also acknowledged the White House has limited his media appearances. The next day, Trump reportedly called Fauci a "disaster" who has been around for "500 years, on a campaign call and referred to him and other health officials as "idiots," according to Reuters. Trump reportedly claimed Americans are tired of hearing about the pandemic and ready to move on, even though cases are spiking and medical experts have warned cases may increase this winter.

Senate Dems ask government watchdog to investigate 'political pressure' on FDA, CDC (ABC News)

Fauci Says Hes Absolutely Not Surprised Trump Contracted Covid-19 (Forbes)

Trump Calls Dr. Fauci Disaster, Says He Would Fire Him It Werent For Negative Press (Forbes)

Full coverage and live updates on the Coronavirus

View original post here:

Watchdog To Investigate Whether Trump Interfered With Health Agencies' Covid-19 Response - Forbes

First@4: Active COVID-19 case record in S.D.; Region in a tense spot; Shooting investigation – KELOLAND.com

SIOUX FALLS, S.D. (KELO) Heres a look at the top stories as of 4 p.m.

Active COVID-19 cases set another record in South Dakota on Monday, based on data from the state Department of Health.

On Monday, 567 new coronavirus cases were announced, bringing the states total case count to 33,836. Total recovered cases are now at 25,125. But active cases, which passed 8,000 for the first time on Sunday, are up to 8,388.

Only eight counties are listed as having moderate community spread; the other 58 counties in South Dakota are listed as having substantial community spread.

Sioux Falls Mayor Paul TenHaken says people in the region need to do more to slow the spread of coronavirus.

We are in a tense spot and we need you to do more, TenHaken said.

He stressed the importance of social distancing and hand hygenine as COVID-19 cases surge in the state.

Wear a dang mask, TenHaken said while referencing a letter sent from mayors of several South Dakota towns with a request to residents.

Sioux Falls Police said a suspect accused of firing a gun at officers died of a gunshot to the head, but the origin of that shot isnt known yet.

The South Dakota Department of Criminal Investigation is looking into the incident.

Two Sioux Falls Police Officers responded to a call about a person who would not leave an apartment. They found the suspect in a hallway just before the suspect fired at one of the officers.

Both officers are on administrative leave.

Snow has fallen across KELOLAND on Monday. Get the latest forecast from the KELOLAND Live Doppler HD StormCenter in the video player below.

The rest is here:

First@4: Active COVID-19 case record in S.D.; Region in a tense spot; Shooting investigation - KELOLAND.com

Gallatin County health official concerned by increase in COVID-19 hospitalizations – The Bozeman Daily Chronicle

The Gallatin City-County Health Department reported Monday there were 15 county residents hospitalized for COVID-19.

Health Officer Matt Kelley said he believes it to be the highest number of people reported to be hospitalized for COVID-19 in a day since the pandemic began. The number refers to Gallatin County residents hospitalized for COVID-19, and includes residents who may be hospitalized in a different county or state.

Birgen Knoff, Bozeman Health system director of clinical practice, said Monday their numbers can change quickly. For example, on Monday morning the health system had 13 patients hospitalized for COVID-19. By the afternoon, that number dropped to 11 patients.

The health department reported 41 new COVID-19 cases on Monday, 57 on Sunday and 59 on Saturday, continuing a trend of increasing case counts in recent weeks. Kelley said last week that the increase in cases there were 175 new cases from Tuesday to Thursday was pressuring the countys contact tracing ability.

It wasnt long ago that we had two to three, maybe four people in the hospital with coronavirus, Kelley said Monday. To have that sort of shift to the norm being seven, eight and nine, and now were up to 15, that is concerning.

Kelley said his concern is compounded by high hospitalization rates in other parts of Montana. According to data from the Montana Department of Public Health & Human Services, both Billings Clinic and Benefis Hospitals in Great Falls had between 70% and 90% of beds occupied as of Oct. 19.

Kelley said the situation elsewhere in Montana limits Bozemans options should hospitalizations increase.

In normal times, if youve got a big surge in Bozeman, Billings would be a primary place that youd get some relief from that, Kelley said.

Knoff said they have transfer agreements with other health systems, but Bozeman Health has not taken on a significant number of patients via transfer agreements recently. Knoff said they created plans to deal with a surge at the beginning of the pandemic that include increasing the number of beds beyond their normal capacity.

On Monday, Bozeman Health had roughly half of its capacity filled, Knoff said.

We feel really good right now about our capacity to take on additional patients with acute care needs, Knoff said.

The health department reported last week a {span}seven-day rolling average for the rate of positive cases{/span} of 10.9% on Thursday, and a seven-day rolling average of daily cases of 42.1 per 100,000 residents. Both were increases from the previous week. The department is seeing increasing cases from all areas of the county in different age categories, Kelley said, and the situation is not getting any better.

Kelley said that the high rate of cases in Bozeman is a specific concern for long-term care facilities.

The more cases you have in the community the harder it is to protect those long-term care facilities, Kelley said. The people who are working in those facilities live in those communities they go out in the world the same as all the rest of us.

To see what else is happening in Gallatin County subscribe to the online paper.

Go here to see the original:

Gallatin County health official concerned by increase in COVID-19 hospitalizations - The Bozeman Daily Chronicle

Galapagos Islands threatened by fishing fleets and COVID-19 – Los Angeles Times

Just south of the Galapagos Marchena Island, theres a dive spot known by locals as the fish arena.

There, within the choppy, cool waters of the Pacific, thousands of colorful fish swim in schools, lobsters poke their long antennae out of rocky outcrops, dolphins bear their young and moray eels gape menacingly at visitors who swim too close.

Charles Darwin documented the rich biota of these islands in the early 1800s. In more recent times, an unofficial network of local tour boats and fishing vessels has worked to protect it, by keeping an eye out for those who might harm the marine bounty. But the pandemic has grounded this surveillance fleet, creating an opening for outsiders.

Earlier this summer, more than 300 Chinese fishing vessels many designed to hold 1,000 tons of catch waited at the marine preserves border, ready to snatch up sea life as it migrated south toward the waters off Peru and Chile.

By some estimates, China has a distant water fishing fleet of 17,000 vessels that has been involved in fishing conflicts off the coasts of West Africa, Argentina and Japan in recent years. Now this fleet is triggering similar anger off Ecuador and Peru, two nations highly dependent on their robust near-shore fisheries.

This is an attack on our resources, said ngel Ynez Vinueza, the mayor of Santa Cruz canton, the Galapagos equivalent of a province. They are killing the species we have protected and polluting our biota with the plastic waste they drop overboard. They are raping the Galapagos.

The fleet is hardly the only threat to this park, a UNESCO world heritage site.

As a result of the COVID-19 pandemic, tourism has plummeted tour boats have been moored in Santa Cruz Islands Academy Bay for months, while shops and restaurants are shuttered along Puerto Ayoras main drag, Avenida Charles Darwin.

It has laid bare the vulnerability of an economic model that is 90% dependent upon tourism dollars, while also highlighting the extraordinary beauty and remoteness of the islands and the magic that is lost when thousands of tourists descend daily into this fragile ecosystem.

The Galapagos marine reserve faces threats from industrial fishing, climate change and reduced funding for conservation.

During a recent visit to the Galapagos, a Times reporting team the only visitors touring the park by boat witnessed penguins swimming alongside tropical fish and sea turtles, krill blooms clouding the shallow waters with pink flotsam, and migrating tuna and hammerhead sharks meandering through the darker, deeper waters.

Normally, pods of dolphins and whales stay out of the busy harbor in Academy Bay. But with the tourist boats out of commission, they are swimming around the area for the first time in decades. Brown pelicans are nesting in the nearby cliffs and mangroves a sight Fiddi Angermeyer, 68, a local tour operator and business owner, says he hasnt seen since he was a kid.

Animals like these Galapagos penguins have flourished as the pandemic keeps visitors away, but the lack of tourism could devastate the parks funding and has left an opening for poachers to move in.

(Carolyn Cole / Los Angeles Times)

The situation has prompted politicians, environmentalists and business owners to wonder how the region can regrow and provide a vibrant economy and jobs for its residents while maintaining the wild essence of the park and tamping down on its carbon-intensive requirements the jet planes and cruising boats of international tourism.

Its like it was 30 or 40 years ago, said Mary Crowley, the director of Ocean Voyages Institute, a Sausalito, Calif., environmental organization working to rid the oceans of plastic. Shes been to the Galapagos 23 times since 1972. That splendor has returned.

Its also exposed the critical role tourism plays in the upkeep and safety of the park: Without visitors traveling to the outer islands and local fishing crews patrolling the parks waters, no one is watching for poaching or picking up the litter and plastic floating in from the mega-fleets and mainland.

The calculus is clear, said Angermeyer: If there are no tourists, there is no park. And if theres no park, there are no tourists.

A world heritage site, the Galapagos marine reserve faces threats from industrial fishing, climate change and a drastic drop in tourism and funding for conservation.

Mosquera Island is not much more than a skinny spit of sand and rock off Baltra Island, where the Galapagos Islands main airport is located.

On a recent afternoon, baby sea lions, Galapagos pigeons and Sally Lightfoot crabs scrambled across the rocks or lolled in the sunbaked sand on Mosqueras southern shore. The airport and the channel separating the islands were largely silent just the sound of waves lapping and sea lion moms and pups barking back and forth.

But a walk around the rocky edge of the island showed something deeply distressing to Fernando Ortiz, a park guide and former director of the regions chapter of Conservation International: Scores of plastic bottles, shoes and equipment packaging labeled with Chinese characters poked out of the jagged rocks.

Fernando Ortiz, a park guide and former director of the regions chapter of Conservation International, picks up bottles, shoes and equipment packaging from the jagged rocks of Mosquera Island in the Galapagos.

(Carolyn Cole / Los Angeles Times)

These are from those boats, said Ortiz, pointing south, toward the horizon, where the fleet of Chinese fishing vessels had congregated roughly 200 nautical miles away. He noted the newness of the items, with labels not faded by sun or sea.

In July, the Ecuadorian navy had become alarmed as the fleet approached the edge of the 200-mile zone around the park where commercial fishing is illegal.

For years, fishing crews have trawled this zone, hoping to capitalize on the fruits of conservation increasingly healthy and robust fish stocks said Boris Worm, a researcher at Dalhousie University in Canada who has studied the fishery.

But last summer, the number of vessels exploded. In late August, a U.S. Coast Guard cutter was called in to help Ecuadors navy patrol the area.

Capt. Brian Anderson, commanding officer of the Coast Guard cutter Bertholf, said the Chinese brought in a tanker ship, which provided fuel to the other ships, and processing ships, where the fishing vessels could dump their harvest and go out and collect more.

It was like a city, he said, noting the fleet had all the pieces it needed to stay out for months without returning to home ports.

Several of the Chinese vessels werent reporting their location electronically, he said, and one was reporting its location as Alaska. But without jurisdiction in the area, and nothing blatantly illegal to report to the Ecuadorian navy, the Coast Guard was relegated to watching, he said.

A Chinese fishing boat off the coast of Peru lights up the surrounding water to attract squid in 2018.

(Simon Ager Photography)

For its part, China has contended it has zero tolerance toward illegal fishing. In a July 23 statement, the Chinese Embassy in Quito said China respects Ecuadors measures to protect the environment and preserve marine resources.

But John Serafini, chief executive of a Virginia-based military defense and commercial data analytics start-up called HawkEye 360, said his companys research which relies on radio frequency and satellite imagery to process movement showed many suspicious signals coming from within the zone this summer.

In 2017, a Chinese fishing vessel intercepted off of the Galapagos was found to be hauling 300 tons of fish, which included tens of thousands of illegally caught sharks.

Mayor Vinueza said the continuing presence of the fleet is an assault on the preserve and his residents livelihood, especially in the face of the economic devastation the park is suffering.

Local fishermen try to sell lobster to boaters in Santa Cruz Islands Academy Bay. The pandemic has caused a desperate economic situation for the residents who depend on tourism in the Galapagos.

(Carolyn Cole / Los Angeles Times)

In August, hundreds of Santa Cruz canton residents took to the streets to protest the fishing fleet worried it was depleting the parks natural resources, potentially giving one more reason for tourists not to return.

On Sept. 24, a commercial flight from Guayaquil to Baltra Island had only nine passengers aboard. Though Avianca Airlines once had daily flights to the island, those have dropped to a sporadic two or three a week.

The lack of tourists has clearly hit the businesses that rely on them, as well as the fishermen and farmers who supply the industry.

Denato Rendon, a local fisherman, has been giving his fish away while his cooperative tries to find new buyers on the mainland and overseas. William and Noralma Cabrera, farmers in the hills outside Puerto Ayora, are also giving food away, and sometimes bartering trading their tomatoes and cucumbers for goods such as fish, chicken or milk.

Were a close-knit community, the father of two said as he stood in front of greenhouses where beans, lettuce and tomatoes were ripening.

The dearth of tourists has also hit the park, which relies on $100 entry fees from visitors. The fees provide money for preservation, conservation, upkeep and enforcement. More than 97% of the Galapagos is protected parkland; the rest is residential.

On Sept. 24, the park pulled in $1,240 from tourist fees at the islands two airports just 4% of last years collection for the same day, said Norman Wray, president of the Government Council of Galapagos.

Noralma Cabrera and her husband, William, are farmers in the hills outside Puerto Ayora. Without tourism driving the economy, theyve started giving food away.

(Carolyn Cole / Los Angeles Times)

We cant keep things going like this, Wray said of the high unemployment and tourism exodus from the islands. To try to counteract that, Wray and others are underscoring the safety of the islands and the seriousness with which the industry takes the pandemic.

Look around you, Vinueza said, it is safe here. We have strict protocols. We wont let the virus in.

Proof of a negative PCR coronavirus test, taken within 96 hours of arrival in the Galapagos, is required for entry. Thats more stringent than the requirement to get into Ecuador, which requires a PCR coronavirus test to be taken within 10 days of arrival.

Seemingly everyone in the now-quiet Puerto Ayora wears a mask, and all businesses require patrons to douse their hands and shoe soles in alcohol before entry. Boat crews are even spraying the hands of scuba divers just emerging from the ocean before they let them back on their boats.

We just cant be too careful, said Ortiz, who works on Angermeyers ship, the Passion, as a guide. And its important that people know how seriously we take this disease.

As a result of the pandemic, tourism has plummeted in the Galapagos and tour boats have been moored in Academy Bay for months, while shops and restaurants are shuttered.

(Carolyn Cole / Los Angeles Times)

Still, theres the sense here that the pandemic may have changed the tourist economy in the islands forever and in some respects, Wray said, that may be for the better.

He noted that broadband cables are being laid along the ocean floor, which soon will connect the islands with high-speed internet making it possible for a high-tech academic center or industry, such as Google or Amazon, to relocate or establish satellite offices in the islands.

What a laboratory to work in, he said, describing the wildness, beauty and history of the islands. And such a prospect, he said, could help park managers imagine a future that didnt require international tourists to board jumbo jets or gas-guzzling pleasure cruisers to meander around the islands.

For the park to survive and its wildlife to thrive, the future of tourism on the island and in the region must change, Wray said.

Though the pandemic and Chinese fishing fleet pose threats, he said, they also have offered a moment for the parks leaders to consider more sustainable models for the Galapagos and the flora and fauna that tourists come to see.

We cant survive without them, he said. But we need to find a balance.

Read more:

Galapagos Islands threatened by fishing fleets and COVID-19 - Los Angeles Times

Remdesivir and interferon fall flat in WHO’s megastudy of COVID-19 treatments – Science Magazine

Patients get tested for COVID-19 in India, one of 30 countries that took part in the Solidarity trial.

By Kai KupferschmidtOct. 16, 2020 , 3:45 AM

Sciences COVID-19 reporting is supported by the Pulitzer Center and the Heising-Simons Foundation.

One of the worlds biggest trials of COVID-19 therapies released its long-awaited interim results yesterdayand theyre a letdown. None of the four treatments in the Solidarity trial, which enrolled more than 11,000 patients in 400 hospitals around the globe, increased survivalnot even the much-touted antiviral drug remdesivir. Scientists at the World Health Organization (WHO) released the dataas a preprint on medRxivlast night, ahead of its planned publication in The New England Journal of Medicine.

Yet scientists praised the unprecedented study itself and the fact that it helped bring clarity about four existing, repurposed treatments that each held some promise against COVID-19. Its disappointing that none of the four have come out and shown a difference in mortality, but it does show why you need big trials, says Jeremy Farrar, director of the Wellcome Trust. We would love to have a drug that works, but its better to know if a drug works or not than not to know and continue to use it, says WHOs chief scientist, Soumya Swaminathan.

The prospects of two of the four treatmentsthe malaria drug hydroxychloroquine and the HIV drug combination ritonavir/lopinavirhad faded after another large study, the United Kingdoms Recovery trial,showed they did not increase survivalin June. After analyzing that study and its own data up until then, WHO decided to drop both from the study.

There was still hope for remdesivir and for interferon-beta, which had initially been given in combination with ritonavir/lopinavir but was tested as a standalone drug after the Recovery data came out. But neither of those treatments lowered mortality or delayed the moment patients needed ventilation to help them breathe. The results in these two treatment arms are likely to be the most scrutinized.

Remdesivir, which attacks a specific enzyme in several RNA viruses and was previously tested against Ebola, was initially seen as a promising candidate. In a U.S. trial with more than 1000 COVID-19 patientspublished last week, those who received remdesivir had a shorter recovery time than patients in the control group, but there was no significant difference in mortality. Two smaller trials found few significant benefits. Remdesivir received an emergency use authorization from the U.S. Food and Drug Administration (FDA) in May for severe COVID-19 patients that was later expanded to include all patients.

But the Solidarity trial suggests the drug does little in severe cases. Of 2743 hospitalized patients who received the drug, 11% died, versus 11.2% in a control group of roughly the same size. The difference is so small it could have arisen by chance.

When the authors pooled Solidaritys data with those from the three other trials, they found a slight reduction in mortality that wasnt statistically significant either. This absolutely excludes the suggestion that remdesivir can prevent a substantial fraction of all deaths, the authors write. The confidence interval is comfortably compatible with prevention of a small fraction of all deaths but is also comfortably compatible with prevention of no deaths.

This trial doesnt help remdesivir, thats for sure, says Eric Topol, director of the Scripps Research Translational Institute. Its not a dead duck as much as hydroxychloroquine, but it certainly is not the hope that was initially signaled.

But the drugs manufacturer, Gilead Sciences, casts doubt on the study. The trial design prioritized broad access, resulting in significant heterogeneity in trial adoption, implementation, controls and patient populations, the companysays in a statement, and consequently, it is unclear if any conclusive findings can be drawn from the study results.

Gilead received the manuscript about Solidarity on 28 September, according to WHO. On 8 October, before the results became public, the company signed a$1 billion deal with the European Commissionfor a 6-month supply of the drug.

Solidaritys most disappointing results, however, are those for interferon-beta, Topol says. Mortality among the 2050 people who received that drug (either alone or in combination with lopinavir/ritonavir) was 11.9%, versus 10.5% in the control group. Prior studies have suggested interferon can only help if given early, however, and not once patients have been hospitalized. So I think thats still an open question, Topol says.

Treating COVID late is very difficult, Benjamin tenOever, a virologist at the Icahn School of Medicine at Mount Sinai, wrote in an email toScience. At this point in the disease the issue is more about inflammation and clotting, which is likely why these four drug regimens showed little value.

The silver lining may be that the trial itself, unprecedented in several ways, succeeded. Set up in a short time in March as the pandemic engulfed the world, it used a simple protocol that allowed doctors in overstretched hospitals anywhere to randomize their patients to whatever study drug was available or to standard care. To get four different drug strategies nailed down, and in this short period of time and across the world, is just fantastic, Topol says. I give them a lot of praise for getting us these results with extraordinary velocity. I think that Recovery and the Solidarity trial between them have set the standard of the scale thats required in order to give you clear answers, Farrar adds.

To get four different drug strategies nailed down, and in this short period of time and across the world, is just fantastic.

The biggest hurdle was the long time it took to get regulatory approval for the study in some countries, says WHOs Marie-Pierre Preziosi. Regulators, as well as the ethics committees for that matter, need to rethink their approaches in pandemics and need to be much more ready to cope with this because sometimes the duration for authorization is really not appropriate.

Still, the trial has ramped up to more than 11,000 patients from 30 countries, including Argentina, Peru, India, the Philippines, and Spain, with more slated to join. About 2000 patients are now included every month. For the moment, the remdesivir arm will continue to get more precise evidence, says John-Arne Rttingen, CEO of the Research Council of Norway, who heads the executive group of Solidaritys steering committee. But new drugs will be added, he says.

As early as next week, Solidarity participants could start to receive acalabrutinib, a cancer drug that inhibits an enzyme that plays an important role in the human immune system. The hope is to soon include targeted therapies such as monoclonal antibodies as well because they are more likely to be successful than repurposed drugs. Trying to find off-target benefits from FDA-approved drugs is not a great strategy (although arguably the best we can do under these conditions), tenOever wrote.

Solidarity built on experience from the 201416 Ebola epidemic in West Africa, says Ana Maria Henao Restrepo, who heads the Research and Development Group at WHO. Back then, there were many debates about whether it was even ethical to do randomized clinical trialswhich withhold a potential therapy from patients in control groupsduring a deadly outbreak. Now, you dont see any debate on that question, she says. The community, all of us, we have moved, we have learned a lot since West Africa.

The studys global reach has important benefits, says Nahid Bhadelia, a physician at Boston Medical Center. Conducting a trial in many places simultaneously means more patients can be included, leading to faster results but also to more robust data, she says. Youre including many different types of subgroups and populations in different parts of the world.

Another advantage: The 1300 participating doctors worldwide will have a sense of ownership of the results, Henao Restrepo says. When they see the results inThe New England Journal of Medicine, [they will] say, Ive contributed to that and I understand why that drug works or doesnt work. I know, I trust it, she says. That is different from some Northern Hemisphere group publishing, and they say: Somewhere in a rich country they did a trial and now we all have to believe the results.

See the rest here:

Remdesivir and interferon fall flat in WHO's megastudy of COVID-19 treatments - Science Magazine

COPD Linked to Three-Fold Greater Mortality Risk in Severe COVID-19 Patients – MD Magazine

The prevalence of comorbid chronic obstructive pulmonary disease (COPD) among patients hospitalized with coronavirus 2019 (COVID-19) is actually lower than its presence in the general population, according to a new observational cohort analysis.

In new data presented online during the American College of Chest Physicians (CHEST) 2020 Annual Meeting this week, investigators reported just 1 in 20 observed patients hospitalized with COVID-19 suffered from COPDversus significantly greater rates of cardiometabolic disease among the most severely ill patients.

Study authors Vikramaditya Samala Venkata, MD, and Gerard N. Kiernan, MD, both of Dartmouth-Hitchcock Medical Center, conducted a systematic electronic search-based assessment of COVID-19 clinical trials to define associations between baseline COPD and overall outcomes of hospitalized patients.

Current understanding of such associations is not yet comprehensive, but nonetheless troubling given the respiratory burden of the pandemic virus.

Although clinical data is limited, studies published so far raise concerns about an association between COPD and worse clinical outcomes in COVID-19, they wrote.

The systematic search included retrospective studies including original hospitalized COVID-19 patient data from any of 3 major databases. Venkata and Kiernan used pooled analysis with a random-effects model in order to interpret the associations between COPD and COVID-19.

Their analyses included 22 studies from 8 countries including 11,000-plus patients hospitalized with COVID-19. Mean patient age was 56 years old, with 58% reported as male.

Among all comorbidities, hypertension was the most prevalent in hospitalized patients, at 42%. Another 23% of patients had diabetes mellitus.

Investigators observed a COPD prevalence rate of just 5% (n = 437) in patients hospitalized with COVID-19. However, such patients faced a three-fold greater risk of mortality (odds ratio [OR], 3.23; 95% CI, 1.59 6.57; P <.05). They noted the global prevalence of COPD among patients >40 years old is approximately 9%.

One explanation may be precautions put in place by COPD patients and their friends, family, and neighbors to limit their risk of COVID-19 exposure, given fears of more severe disease risks for such patients.

While one would expect patients with prior lung disease to have greater mortality with COVID-19, it is curious to see that the prevalence of COPD was lower than the general population may reflect greater measures taken by COPD patients to avoid coronavirus exposure, investigators wrote.

Uniquely, Venkata and Kiernan also found that smoking was present in more than one-third (37%) of COVID-19 patientsyet patients who smoked faced only a 52% worsened risk of disease severity (OR, 1.52; 95% CI, 0.81 2.87; P = .20). Reasoning for a mixed association, they noted, is still unclear.

Investigators concluded that more randomized trials are necessary to understand relationships between COPD, smoking status, and hospitalized COVID-19 prognosis in patients.

This will alert clinicians to the worse prognosis of COVID-19 infection in patients with history of COPD and it will raise a question for future studies to look at the association between baseline COPD and COVID-19, they concluded.

The study, COVID-19 and COPD: Pooled Analysis of Observational Studies, was presented at CHEST 2020.

More here:

COPD Linked to Three-Fold Greater Mortality Risk in Severe COVID-19 Patients - MD Magazine

2 more local residents die of COVID-19 as new cases identified near The Villages – Villages-News

Two more local residents have lost their battles with the COVID-19 virus as cases continue to be identified just outside the confines of The Villages.

One of the latest fatalities was from Sumter County and the other was a resident of Marion County. They were identified Monday by the Florida Department of Health as:

No new cases of COVID-19 were reported in The Villages on Monday. In fact, three cases that had been attributed to mega-retirement community were removed from the overall list, bringing the total (Sumter, Lake and Marion counties) to 764. But 17 new cases were reported in communities just outside the confines of Floridas Friendliest Hometown. Those include:

Sumter County is now reporting 2,754 cases a decrease of two from Sunday to Monday among 1,562 men, 1,171 women, 10 non-residents and 11 people listed as unknown. A total of 206 cases have been reported in long-term care centers and 739 in correctional facilities. There have been 80 deaths and 270 people treated in area hospitals.

The Villages continues to pace Sumter County with 718 cases. Besides those mentioned above in Wildwood, others have been identified in Coleman (656), Bushnell (323, 140 of which are at the Sumter Correctional Institution among 103 inmates and 37 staff members), Oxford (139), Webster (100), Lake Panasoffkee (85), Center Hill (55), Sumterville (47) and the Lady Lake portion of the county (42). The federal prison in Coleman also is reporting 155 cases among 51 inmates and 104 staff members.

Below is a breakdown of other COVID-19 activity in the local area:

TRI-COUNTY AREA

LAKE COUNTY

MARION COUNTY

All told, Florida is reporting 756,727 COVID-19 cases an increase of 1,707 from Sunday to Monday. Of those, 747,183 are residents. A total of 49,401 cases have been reported in long-term care centers and 23,682 in correctional facilities. Across the state, there have been 16,222 deaths and 47,125 people have been hospitalized.

Read more here:

2 more local residents die of COVID-19 as new cases identified near The Villages - Villages-News

Covid-19 deaths will rise almost 80% by February, researchers foresee – CNN

The model, from the Institute for Health Metrics and Evaluation at the University of Washington School of Medicine, forecasts there will most likely be about 389,087 deaths -- or 78% more fatalities -- by February 1.

The model's best-case scenario projects 314,000 deaths by then if all Americans use masks. There could be more than 477,000 deaths if mask mandates are eased, it projects.

The data show the pandemic increasing in younger populations -- and thus fewer deaths than a previous forecast. That model, released five days ago, projected about 395,000 deaths by February 1.

"We expect deaths to stop declining and begin increasing in the next one to two weeks," researchers with the institute said. "The winter surge appears to have begun somewhat later than the surge in Europe. Daily deaths will reach over 2,000 a day in January even with many states reimposing mandates before the end of the year."

21 states reach record 7-day average of new cases

As of Thursday, the nation is averaging 52,345 new cases a day, up 16% from the previous week, a trend that concerns health experts as we head into the cooler months.

"This is a very ominous sign. I think we're in for a pretty bad fall and winter," said Dr. Peter Hotez, professor and dean of tropical medicine at the Baylor College of Medicine.

"This is the time when we could be entering one of the worst periods of our epidemic and one of our worst periods in modern American public health," he said. "I'm very worried for the nation."

Thirty-five states are showing increases in new Covid-19 cases greater than 10% over the last week compared to the prior week. In seven states, cases are up less than 10%.

Only eight states -- Alabama, Delaware, Hawaii, Kentucky, Louisiana, Maine, Texas and Vermont -- are showing decreases in new cases compared to the previous week.

Since Sunday, 21 states have hit their peak 7-day average of new cases since the pandemic began, according to Johns Hopkins data, those being Alaska, Colorado, Idaho, Illinois, Indiana, Kansas, Kentucky, Minnesota, Missouri, Montana, Nebraska, New Mexico, North Dakota, Ohio, Oklahoma, Oregon, South Dakota, Utah, West Virginia, Wisconsin and Wyoming.

That kind of spread is "quite concerning," Dr. Anthony Fauci said Thursday on ABC's "Good Morning America."

"The issue is that as we enter, as we are now, in the cooler season of the fall, and ultimately the colder season of the winter, you don't want to be in that compromised position where your baseline daily infection is high and you are increasing as opposed to going in the other direction," Fauci said.

"We need to think about what we need to do as individuals," she said, "and how each of the decisions that we make can actually contribute to bringing this pandemic to an end."

Herd immunity is not the way out of pandemic, experts say

Wisconsin reported 3,747 new Covid-19 cases on Thursday -- a daily record, according to the state's Department of Health Services. That prompted Gov. Tony Evers to urge residents to help get the spread under control by staying home and wearing face coverings when out.

"The longer it takes for everyone to take this virus seriously, the longer it will take to get our economy and our communities back on track," Evers said at a news conference.

Arkansas, Illinois, Michigan, North Carolina and Ohio also reported their highest single-day totals on Thursday, though Michigan's data included a backlog of cases.

And Florida reported 3,356 cases on Thursday, the 11th day this month that the state Department of Health reported at least 2,200 new cases in a single day, according to CNN's tally.

Vaccine is the best weapon, expert says

Frieden was responding to recent efforts to promote herd immunity as an answer to Covid-19. The idea is being pushed by those eager to stop the economic damage the pandemic has caused.

White House senior administration officials, in a call with reporters Monday, discussed a controversial declaration written by scientists that advocates such an approach.

But the idea is "a dangerous fallacy unsupported by scientific evidence" that risks "significant morbidity and mortality across the whole population," 80 scientists from around the world wrote in an open letter.

"Any infection anywhere is potentially a threat somewhere else because even if you feel fine and get over it with no problems, no long-term consequences, you might spread it to someone who dies from it. And that's what we're seeing all over the country," Frieden said.

It is impossible to keep only the vulnerable protected from the spread, Frieden said. And letting the virus run rampant would likely lead to recurring epidemics because there is no evidence that people are protected long-term after they have been infected, according to the letter.

The best way to achieve widespread immunity, Frieden said, will be through a vaccine.

"The concept (of herd immunity) really comes from vaccines," Frieden said. "When you vaccinate enough people, the disease stops spreading, and that might be 60%, 80%, 90% for different diseases."

Frieden's comments were echoed Thursday by the WHO's Van Kerkhove, who said that allowing the virus to spread for the sake of herd immunity would lead to "unnecessary cases" and "unnecessary deaths."

"This is not a strategy for this virus," she said, "because there is so much that we can do."

CNN's Maggie Fox, Amanda Watts, Shelby Lin Erdman, Christina Maxouris Raja Razek, Lauren Mascarenhas, Jennifer Henderson, Rebekah Riess and Gisela Crespo contributed to this report.

Link:

Covid-19 deaths will rise almost 80% by February, researchers foresee - CNN

COVID-19 Daily Update 10-9-2020 – West Virginia Department of Health and Human Resources

TheWest Virginia Department of Health and Human Resources (DHHR) reports as of 10:00 a.m., October 9,2020, there have been 617,045 total confirmatorylaboratory results received for COVID-19, with 17,707 totalcases and 376 deaths.

DHHR has confirmed the deaths of a 74-yearold female from Kanawha County, a 64-year old male from Cabell County, a 70-yearold female from Logan County, a 65-year old male from Wayne County, a 68-yearold female from Jackson County, and a 61-year old female from Fayette County. Wecontinue to grieve the loss of more West Virginians today, said Bill J.Crouch, DHHR Cabinet Secretary. Our deepest sympathies are expressed to theirfamilies.

CASESPER COUNTY: Barbour(130), Berkeley (1,187), Boone (267), Braxton (16), Brooke (128), Cabell (978),Calhoun (29), Clay (48), Doddridge (40), Fayette (678), Gilmer (50), Grant(169), Greenbrier (142), Hampshire (115), Hancock (165), Hardy (98), Harrison(498), Jackson (311), Jefferson (470), Kanawha (3,054), Lewis (47), Lincoln(195), Logan (688), Marion (318), Marshall (196), Mason (154), McDowell (96),Mercer (450), Mineral (181), Mingo (427), Monongalia (2,135), Monroe (166),Morgan (73), Nicholas (136), Ohio (408), Pendleton (55), Pleasants (20),Pocahontas (60), Preston (168), Putnam (675), Raleigh (596), Randolph (303),Ritchie (18), Roane (65), Summers (62), Taylor (151), Tucker (44), Tyler (20),Upshur (168), Wayne (428), Webster (9), Wetzel (67), Wirt (19), Wood (401),Wyoming (135).

Please note that delaysmay be experienced with the reporting of information from the local healthdepartment to DHHR. As case surveillance continues at the local healthdepartment level, it may reveal that those tested in a certain county may notbe a resident of that county, or even the state as an individual in questionmay have crossed the state border to be tested.

Please visit the dashboard located at http://www.coronavirus.wv.gov for more information.

Free COVID-19 testing locations are available today in Mingo, Nicholas, Taylor, and Wood counties, and Saturday in Wood County:

Mingo County, October 9, 10:00AM 2:00 PM, Delbarton Volunteer Fire Department, County Highway 65/12, Delbarton,WV

Nicholas County, October9, 1:00 PM 4 PM, Nazarene Camp, 6461 Webster Road, Summersville, WV

Taylor County, October 9,12:00 PM 2:00 PM, First Baptist Church of Grafton, 2034 Webster Pike (US Rt.119 South), Grafton, WV

Wood County, October 9:10:00 AM 6:00 PM, South Parkersburg Baptist Church, 1655 Blizzard Drive, Parkersburg,WV

Wood County, October 10:9:00 AM 4:00 PM, South Parkersburg Baptist Church, 1655 Blizzard Drive, Parkersburg,WV

Testing is available to everyone,including asymptomatic individuals. For upcoming testing locations, pleasevisit https://dhhr.wv.gov/COVID-19/pages/testing.aspx.

Go here to see the original:

COVID-19 Daily Update 10-9-2020 - West Virginia Department of Health and Human Resources


12345...102030...