That number is far beyond the country's current capacity, according to the report released Wednesday by the Rockefeller Foundation and the Duke-Margolis Center for Health Policy.

"The U.S. will likely need very large numbers of all types of Covid-19 tests well into 2021 to contain outbreaks while returning toward normal activity, with a particular need for more screening tests that have very fast turnaround times," the report reads.

Public health experts across the country have for months said testing will play a critical role in helping to reel in the pandemic. Getting enough people tested -- and getting their results back quickly -- will aid contact tracers in tracking down Americans exposed to the virus and help control outbreaks.

Fewer than 30 million tests are currently reported monthly in the country, the report says. As the virus ran unabated across American communities over the summer, some officials said contact tracing was nearly impossible with the lack of testing capacity and the uncontrolled spread.

Adm. Brett Giroir, the testing lead for the White House Coronavirus Task Force, has said repeatedly the US cannot test its way out of the pandemic.

Echoing other officials' claims, the report from the team of experts says more testing is vital.

"At present infection rates, a basic screening strategy will require approximately 200 million tests each month for students and staff at the nation's primary and secondary schools and residents and staff at nursing homes for them to open safely and in stages," the team wrote.

But things could turn around. Testing capacity is improving and companies are working to develop fast and cheap on-the-spot tests that -- if distributed widely enough --- could make a difference, the report says.

"By October 2020, based on recent and announced expected market entry, point-of-care tests will rise to at least 70 million tests per month," the team wrote.

By January, the US could reach nearly 200 million tests monthly. And more growth is possible, the experts said.

'We will end this crisis'

Both US leaders and Americans throughout the country for months have pushed for a return to normalcy. But experts have said ignoring the necessary safety guidelines and protocols will only further the crisis.

In a hopeful message this week, the nation's leading infectious disease expert said the US will eventually get on top of the pandemic.

"There will be an end to this," Dr. Anthony Fauci said at an event sponsored by Research! America. "When people know there's an end in sight, they can hang on a bit longer."

Fauci acknowledged the pandemic fatigue many are facing, exhausted of the lingering measures in place to protect against the virus, but said now is not the time to let up.

"It's when they throw their hands up in exasperation and say, 'This is never going to end, so to heck with it. Why don't we just get on with our lives and do what we want to do?' That can be a very dangerous conclusion to arrive at, because it leads to carelessness, and even more infections and the propagation of the pandemic."

One major coronavirus vaccine trial hits pause

The company said the volunteer affected is in Britain, but its trials worldwide would be but put on hold. But this doesn't mean an end to the trial.

For one, the stop may be temporary and the illness may not have been caused by the vaccine. The company is making sure before it goes ahead with more testing.

"This is a routine action which has to happen whenever there is a potentially unexplained illness in one of the trials, while it is investigated, ensuring we maintain the integrity of the trials," the company said in a statement.

"In large trials, illnesses will happen by chance but must be independently reviewed to check this carefully," the company said.

The company didn't give details on the illness.

Two other Phase 3 vaccine trials

There are two other vaccine candidates in Phase 3 trials, one developed by Moderna, another by Pfizer and its German partner, BioNTech. All three have US government funding and backing.

"It has an excellent profile and I consider this vaccine ... near perfect, and which has a near perfect profile," Sahin said.

Pfizer and BioNTech say they plan to provide 100 million doses of their vaccine candidate, BNT162, by the end of the year, and up to 1.3 billion doses in 2021.

AstraZeneca's pause on trials could give the public more confidence that companies are sticking to the safety first rule, despite the push from President Trump to get a vaccine out more quickly.

CNN's Lauren Mascarenhas contributed to this report.

See the original post:

The US needs 200 million tests a month to reel in Covid-19, report says. It's now testing 30 million - CNN

Many stranded crew members said governments should do more to accommodate crew changes. Ports and countries want the cargo, but when it comes to the crew who are bringing the cargo to them, they are not helping us, said Nilesh Mukherjee, the chief officer on a tanker carrying liquid petroleum gas, who is from India.

Even in normal times, replacing a crew member involves complex logistics, said Frederick Kenney, director of legal and external affairs at the International Maritime Organization, a U.N. agency that oversees global shipping.

Leaving a ship, and getting home, requires more than just disembarking. It usually involves multiple border crossings, flights with at least one connection, and a slew of certificates, specialized visas and immigration stamps. A crew members replacement has to go through the same steps.

Every step in that procedure is broken because of the pandemic, with flights limited, border controls tightened and many consulates closed, according to Mr. Kenney. While some countries have found ways around the problem, the rate of progress is not keeping up with the growing backlog of seafarers, he said last week.

Some ports have exempted crew members from border restrictions, then backtracked after seafarers, arriving from their home countries to report for duty on a ship, were found to have Covid-19.

Hong Kong exempted sea as well as airline crews from a 14-day quarantine requirement, but it changed those rules in July, after the exemptions were blamed for a surge in case numbers. In Singapore, too, protocols were tightened after seafarers tested positive for the virus on arrival.

The rest is here:

Sailors Trapped by Covid-19 Fight Exhaustion and Despair - The New York Times

OUTBREAK REPORTAlso on Tuesday, Gov. Justice announced that school-related COVID-19 outbreaks have been identified within 11 facilities in five counties across the state.

These outbreaks have been identified in Brooke County at Brooke Middle School and Brooke Intermediate North; Kanawha County at Ben Franklin Career and Technical Center, Cedar Grove Middle School, Chamberlain Elementary School, Horace Mann Middle School, Shoals Elementary School, and Sissonville High School; Lincoln County atDuval PK-8 School; Mason County atPoint Pleasant Primary School; and Mingo County atMingo Central High School.

Meanwhile, the Governor added that a new church-related outbreak of COVID-19 has been identified in Kanawha County. Other church-related outbreaks remain active inCabell, Monroe, Wayne, and Wyoming counties at this time.

There are now 34 outbreaks in long-term care facilities across the state, down from 35 on Friday.

Within corrections facilities, Mount Olive Correctional Complex in Fayette County did not see any new cases of COVID-19 over the weekend. Their number of active cases remains at 134.

Meanwhile, South Central Regional Jail in Kanawha County and Western Regional Jail in Cabell County each have one active case among their inmate populations.

Across the entire DCR system, a total of 37 employees have active cases at this time.

Click here to view the latest corrections facility update

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COVID-19 UPDATE Gov. Justice discusses first day of school; announces nearly 850 Kids Connect WiFi locations online - West Virginia Department of...

Despite a resurgence of the virus in France, officials from the French Tennis Federation announced on Monday that they will allow spectators at the French Open, which will take place from Sept. 27 to Oct. 11. The plans have been scaled back, however, to 11,500 people a day.

Roland Garros stadium, where the tournament is held, stretches across almost 30 acres and will be split into three separate zones. The two larger ones will allow 5,000 people each; the third will allow 1,500. Normally, the stadium holds about 35,000 people.

The French Tennis Federation, with advice from a committee of expert scientists, is acting responsible and in close collaboration with the French government authorities to draw up a strict protocol that will ensure the health and safety of everyone who is on site at Roland Garros stadium during the tournament, the officials said.

The U.S. Open is currently underway at the Billie Jean King National Tennis Center in Queens, but without any fans in the stadium. The French Open, usually played in late May, was pushed to September because of the pandemic.

In early July, Bernard Giudicelli, the president of the French Tennis Federation, said the tournament may be able to accommodate 20,000 fans per day. At that time, the seven-day average for the daily number of new cases was about 700, according to a New York Times database. In the two months since, the seven-day average has risen to more than 5,000, rivaling the first peak of cases in April. On Friday alone, there were nearly 9,000 new cases.

Spectators will not be able to move between zones of the stadium and everyone over the age of 11 will have to wear face coverings.

Read more:

Parties and Covid-19 Outbreaks Threaten University Reopenings in the U.S. - The New York Times

A reminder: We are holding a DealBook Debrief call on Thursday as part of The Timess special project for the 50th anniversary of the seminal Milton Friedman essay that changed the course of capitalism. Joining us are special guests Leo Strine Jr., the former Delaware chief justice, and Joey Zwillinger, the C.E.O. of the shoe company Allbirds. R.S.V.P. here for the call tomorrow at 11 a.m. Eastern.

Want this delivered to your inbox each day? Sign up here.

The conventional wisdom is that a coronavirus vaccine will be widely available by next summer, if not earlier. But AstraZenecas move to halt testing of its treatment calls that into question and puts into doubt how quickly the global economy can recover from the pandemic.

AstraZeneca is investigating a serious suspected adverse reaction in a volunteer in a late-stage U.K. trial. It isnt clear whether the illness is linked to the companys vaccine, or for how long the drug maker will keep its trial on hold. The AstraZeneca vaccine, which is being developed with Oxford University, is reportedly under consideration by the Trump administration for fast-track approval.

To be clear, this isnt necessarily a bad thing. Medical experts say the point of late-stage clinical trials is to uncover potential side effects by giving thousands of people a treatment under controlled conditions. The perspective we need to keep in mind, said Dr. Faheem Younus, the chief of infectious diseases at the University of Maryland Upper Chesapeake Health, is this one potential case of a serious side effect versus the tens of thousands of Covid-19 patients currently hospitalized in the U.S.

AstraZeneca was one of nine pharmaceutical companies to sign a public pledge not to submit their coronavirus vaccines for authorization until the treatments have been cleared in clinical trials.

Still, the move raises several issues about life without a vaccine:

Coronavirus infections appear to be leveling off in the U.S., but at a persistently high level, and experts fear a flare-up in the fall. That could lead to more government-imposed social restrictions, something that countries like Britain are reintroducing amid a resurgence in cases.

Treatments for coronavirus infections, such as remdesivir and antibody drugs, will assume more importance. But theyre also subject to the same questions of safety, efficacy and availability as vaccine candidates.

Widespread coronavirus testing at airports, schools, workplaces, restaurants and more will become even more critical to restoring the publics confidence. But the capacity to manufacture and use virus tests, particularly in the U.S., is limited. How quickly can that be ramped up?

What path will the economic comeback take if a vaccine doesnt come for a long time? Inequality created by a K-shaped recovery, in which circumstances for wealthy people who can afford to isolate are improving and those for everyone else are not, could worsen.

____________________________

Todays DealBook Briefing was written by Andrew Ross Sorkin in Connecticut, Lauren Hirsch in New York, and Michael J. de la Merced and Jason Karaian in London.

____________________________

The $16.2 billion deal between LVMH and Tiffany, agreed in November but recently delayed by the pandemic, looks even less certain today. LVMH said it could not complete the deal, and Tiffany has filed a lawsuit to force LVMH to go ahead with it.

There has been concern for months that LVMH would seek to renegotiate the deal, in light of the stress the pandemic has put on the jewelry business. LVMH said in a statement that it wouldnt do the deal as it stands, citing a request from the French government to delay the acquisition beyond Jan. 6 because of the threat of U.S. tariffs on French goods.

Tiffany claims that LVMH is in breach of its contract. It rejects the idea that LVMH can avoid the deal by claiming that Tiffany has undergone a material adverse effect that would have breached its merger obligations. Its lawsuit, filed in Delaware, also says that LVMH cannot avoid completing the deal because it is in some way inconsistent with its patriotic duties as a French corporation.

DealBook hears that Tiffany decided to sue LVMH over frustration that 10 months after the deal, it had not yet filed for deal approval in the European Union.

Markets tumbled again, with tech leading the way down. Another sharp sell-off in tech stocks yesterday led to the Nasdaqs falling over 4 percent reaching correction territory and the S&P 500 slipping nearly 3 percent. Tesla shed a quarter of its value, in part because it wasnt included in the S&P 500 index (more on that below). Futures are currently looking up, though, suggesting an end to the three-day slide.

Senate Republicans plan to vote on their skinny coronavirus aid bill. The move is meant to put pressure on Democrats to compromise on economic stimulus measures. House Democrats have rejected the $500 billion proposal as pathetic, and even some Senate Republicans are likely to oppose it.

JPMorgan Chase said customers and workers had misused federal relief money. The bank said it had found instances of customers misusing Paycheck Protection Program loans, unemployment benefits and other government programs. JPMorgan said it was cooperating with law enforcement.

New York real estate faces its biggest challenge since the financial crisis. Under 10 percent of New Yorks office workers had returned as of last month, and just 54 percent of companies plan to return by July, The Times reports. Businesses have increasingly put off decisions to sign new leases, and some are holding out for steeper discounts than are now on offer.

The first day of school in the U.S. didnt go smoothly. Website crashes and cyberattacks bedeviled many students logging on remotely. A lot of districts are just wildly unprepared for online learning, one expert told The Times. College students attending in-person classes arent faring much better: Tens of thousands have been infected with the coronavirus, and universities are resorting to lockdowns.

Steven Davidoff Solomon, a.k.a. the Deal Professor, is a professor at the U.C. Berkeley School of Law and the faculty co-director at the Berkeley Center for Law, Business and the Economy. Here, he and Panos N. Patatoukas, a professor at Berkeleys Haas School of Business, run the numbers on Tesla and try to make sense of its volatile valuation.

Its been a torrid time for Tesla, which has lost a third of its value over the past week or so. Yesterday alone it erased 21 percent in value, leading another down day for technology stocks. It follows an amazing bull run for tech stocks in general and Tesla in particular.

Is the correction warranted?

Lets look at it through the eyes of Tesla investors. What did they need to believe about its path ahead to have been willing to value Tesla at almost $500 billion in market capitalization at its recent peak?

We can apply traditional valuation techniques to see what would need to happen for this valuation to be justified. In theory, a companys fundamental value is the capital in place plus the expected added value. Value added, the theory goes, should be based on investors expectations about growth and profitability. Using this basic framework, we recasted the Tesla story in terms of fundamental projections over a 10-year horizon.

There are two key aspects: sales growth and profit margins.

If Tesla is going to justify a half-trillion market capitalization, it needs to increase its sales from $24.6 billion in 2019 to approximately $140 billion by 2030. This would require an annualized growth rate of 19 percent, and end up with the company becoming as big as G.M. and Ford are today.

At the same time, Tesla also needs to expand its net profit margin, the money earned for shareholders per dollar of sales. By our calculations, its net margin will need to increase from minus 3.5 percent in 2019 to over 21.5 percent by 2030. That means that by 2030 Teslas margin would converge to what Apples is today. Toyota is among the most profitable big automakers, and its margin in its latest fiscal year was around 7 percent.

Over all, if you were willing to buy Teslas shares at their recent peak, then you should also be willing to believe that over the next decade Tesla will achieve the scale of Ford or G.M. with the margins of Apple. This implies that Tesla would become more than a car company: It would have to become a renewable technology company in which cars are only a small part of its business. Elon Musks moves into solar panels and batteries suggests that he understands this.

Eventually, expectations reflect reality and fundamental valuation drivers come into play. That said, expectations may take a long time to correct themselves if investors arent very focused on fundamentals. Its possible that Tesla and other hot tech stocks will justify their recent highs, but a lot needs to go right in the long term. Perhaps investors are starting to realize this, and revising their expectations.

One of the best-known advisers to companies on ethics and compliance, LRN, will announce today that it is buying a rival to expand internationally. It comes as the New York-based firm capitalizes on companies growing interest in overhauling their corporate cultures at a time of social justice movements.

LRN plans to acquire Interactive Services, a Dublin-based provider of compliance and online learning programs. Interactive Services clients include Biogen, BNP Paribas, Citigroup, FedEx and Hershey. The combined company will count about 40 percent of the Fortune 500 as clients. The terms of the deal were not disclosed.

The deals roots lie in a 2018 investment by Leeds Equity Partners, a capital infusion intended to help LRN increase its share in an estimated $3 billion market for ethics and compliance training.

The sorts of services that LRN provides are in high demand. We are being asked to help companies create powerful codes of conduct that help their people genuinely live company values, said Dov Seidman, LRNs founder and chairman. At DealBooks 2018 summit, Mr. Seidman was named a Groundbreaker for his role in changing the business world. You will be much more effective if you earn the moral authority to lead rather than rely on the formal authority that goes with your title, he said at the time.

Eric Ries is launching the Long-Term Stock Exchange today, nine years after his book The Lean Startup laid the foundations of the concept and made him a mini-celebrity in Silicon Valley.

The big idea: LTSEs pitch is that it makes it easier for companies to manage for you guessed it the long-term instead of obsessing about quarterly targets. The risks of short-term thinking have been called out by the likes of Jamie Dimon and Warren Buffett, and the embrace of stakeholder capitalism has questioned the wisdom of serving shareholders alone.

The exchange says its more than just marketing. Companies that list on the San Francisco-based exchange are required to report on and maintain a series of principles that focus on long-term value creation. This should appeal to institutions like pension funds that tend to take a longer-term view of returns, Mr. Ries said. He dismissed concerns that even companies with the best intentions could find themselves vulnerable to activist investors or takeover threats, forcing them to make short-term, defensive moves. The bullying tactics only work if youre actually afraid, Mr. Ries said.

It doesnt have any companies signed up yet. Today is the starting gun in which LTSE can begin the solicitation process, beginning with companies that have yet to go public. Asana has explored the prospect of listing on LTSE, people familiar with the matter said, as has Airbnb, The Times has reported. I think this is such a seismic change that to get even one company to do it is unbelievable, Mr. Ries said.

One of the companies that lists on LTSE may be the LTSE itself. The company would not consider exploring a sale, but would consider going public on its own exchange, of course.

Deals

Berkshire Hathaway will invest $570 million in the I.P.O. of Snowflake, the cloud database company, in a rare bet by Warren Buffett on enterprise tech. (FT)

G.M. agreed to take an 11 percent stake in the electric truck maker Nikola, valuing the start-up at nearly $19 billion. (NYT)

The merger of the digital ad companies Outbrain and Taboola has fallen apart nearly a year after the deal was announced. (CNBC)

Sard Verbinnen, the public relations firm, agreed to buy Oakhill Communications of Britain to bolster its U.K. practice. (Sard Verbinnen)

Politics and policy

In an unusual move, the Justice Department is seeking to replace President Trumps private counsel in a defamation suit. (NYT)

Britains top government lawyer quit yesterday amid plans to override the countrys Brexit treaty with the E.U. (NYT)

Tech

Uber plans to spend $800 million by 2025 to help drivers switch to electric vehicles, as part of a pledge to make all rides emissions-free by 2040. (Bloomberg)

Apple countersued Epic Games over their App Store dispute, accusing the Fortnite developer of plotting to violate payments rules. (The Verge)

Best of the rest

The reality TV hit Keeping Up With the Kardashians is calling it quits after 20 seasons. (LA Times)

If you received a package of mystery seeds from China in the mail, would you plant them? These Americans did. (Vice)

Is Zoom on the road to genericide? (Quartz)

Correction: In yesterdays newsletter, we should have said that Deval Patrick is a former executive at Bain Capital, not a current one. He resigned last November to pursue a presidential bid; the return to politics is why some think hes in the mix for a top post in a Biden administration.

Wed love your feedback. Please email thoughts and suggestions to dealbook@nytimes.com.

Continue reading here:

What if There Isnt a Covid-19 Vaccine for Years? - The New York Times

TheWest Virginia Department of Health and Human Resources (DHHR) reportsas of 10:00 a.m., on September 6, 2020, there have been 458,180 total confirmatory laboratory results receivedfor COVID-19, with 11,412 total cases and 246 deaths.

DHHRhas confirmed the deaths of an 81-year old male from Kanawha County, an 83-year old female fromLogan County, and a 68-year old male from Monroe County. Asmany West Virginians are growing tired of the thought of COVID-19, we must,more than ever, stay vigilant in our efforts to prevent further spread andrealize that the virus is among us, said Bill J. Crouch, DHHR CabinetSecretary. We extend our sympathies to these families for their profound loss.

CASESPER COUNTY: Barbour (35), Berkeley (825), Boone(154), Braxton (9), Brooke (102), Cabell (580), Calhoun (17), Clay (29),Doddridge (11), Fayette (412), Gilmer (20), Grant (144), Greenbrier (106),Hampshire (93), Hancock (125), Hardy (75), Harrison (297), Jackson (211),Jefferson (388), Kanawha (1,686), Lewis (36), Lincoln (126), Logan (520),Marion (227), Marshall (133), Mason (119), McDowell (74), Mercer (349), Mineral(146), Mingo (276), Monongalia (1,371), Monroe (136), Morgan (40), Nicholas(57), Ohio (296), Pendleton (45), Pleasants (15), Pocahontas (45), Preston (141),Putnam (340), Raleigh (390), Randolph (228), Ritchie (6), Roane (36), Summers(21), Taylor (110), Tucker (12), Tyler (15), Upshur (45), Wayne (285), Webster(7), Wetzel (45), Wirt (8), Wood (322), Wyoming (71).

Pleasenote that delays may be experienced with the reporting of information from thelocal health department to DHHR. As case surveillance continues at the localhealth department level, it may reveal that those tested in a certain countymay not be a resident of that county, or even the state as an individual inquestion may have crossed the state border to be tested.Such is the case of Marionand Upshur counties in this report.

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

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COVID-19 Daily Update 9-6-2020 - West Virginia Department of Health and Human Resources

The KVIBE bike shop in Kalihi is normally packed with kids. The warehouse along Kamehameha IV Road is walking distance from multiple public housing complexes, and the organization takes seriously its mission to help mentor kids and get them off the streets.

But when the COVID-19 pandemic hit, the warehouse transformed.

We turned our shop into a food hub, explains Josh Kim, who works at the youth outreach bike shop thats part of the Kokua Kalihi Valley Comprehensive Health Center.

Before COVID-19 started spreading in Hawaii, kids worked on their bikes at KVIBE in Kalihi. The bike shop became a food hub when the pandemic hit.

Cory Lum/Civil Beat

By late May, more than 21% of Kalihi residents had filed for unemployment and others were still struggling to do so. KVIBE partnered with the YMCA of Kalihi to give out up to 150 meals per day to families in need. Six months into the pandemic, Kim and other staff spend their days delivering food throughout the neighborhood.

The pivot was a necessity in Kalihi, where the pandemic has hit harder than every other part of the state. State data shows the 96819 zip code reported 1,396 total cases thus far, the highest of any zip code in the state. Nearly two-thirds were identified in the last 28 days.

Thats 261 cases per 10,000 people, more than twice the islandwide rate. And its worsening in August, about 30% of Kokua Kalihi Valley patients who got tested for coronavirus received positive test results.

Our community is in crisis right now and we are doing our best to come together, said Puni Jackson, a KKV staffer.

Puni Jackson says the story of COVID-19 disparities is the story of Kalihi.

Anita Hofschneider/Civil Beat

Kalihi has long been home to many recent immigrants from the Philippines and Oceania. Non-Hawaiian Pacific Islanders make up 31% of Hawaii coronavirus cases, compared with just 4% of the population. Both Pacific Islanders and Filipinos are disproportionately dying from coronavirus in Hawaii.

But Jackson said while media coverage about the pandemic has often focused on high rates among ethnic groups, that data doesnt tell the full story.

It really is about Kalihi, Jackson said. Every new wave of people that comes into this place struggles.

Councilman Joey Manahan, a Filipino immigrant himself, has been anxiously watching the pandemic worsen in his district.

I just saw the numbers going up in 96819, he said. Theres got to be a reason for that.

Councilman Joey Manahan is glad to see more testing in Kalihi. He is pictured on a day of COVID-19 testing at KPT.

Anita Hofschneider/Civil Beat

He thinks the fact that many families live in dense, multi-generational households in Kalihi is contributing to COVID-19s spread.

Because they dont have the space to quarantine properly, Im hearing the numbers are going up every day, he said.

Access to testing is also a concern. Its hard to make time to get tested when youre working multiple jobs, he explains. Or if youve lost your job, you might be afraid of how much testing could cost, he said.

The city has been offering free testing in the district this month as part of a statewide surge-testing effort. But once they test positive, people have struggled to figure out what to do once they get sick, even though the state has been trying to improve outreach to patients.

People are left in the dark having to fend for themselves not really knowing what to do, Manahan said. People are not necessarily getting the information that they need. They dont want to violate stay-at-home orders. They dont want to make anyone sick but they are also going hungry.

During the first stay-at-home order, Kalihi residents were more likely to get arrested for violations than other Honolulu residents, according to a Hawaii Public Radio analysis.

Even before the pandemic, the community faced health challenges. In some parts of Kalihi, life expectancy is 76 years on average, compared with 82 years island-wide.

But the health impacts of the pandemic are nearly inseparable from the economic impacts, as statewide shutdowns cause massive job losses in the hospitality and service industries. And service providers say thats driving up hunger.

Individuals and community organizations are pivoting their missions to try and meet that need.

Every weekday, a line of vans deep in Kalihi Valley gets ready to drop off food and supplies to COVID-19 patients, kupuna and others who are stuck at home due to the pandemic. They leave from Hooulu Aina, a 100-acre nature preserve managed by the KKV community health center. Normally, the valley hosts weekly and monthly gatherings of volunteers who work on growing local food. Thats all been canceled since the pandemic hit.

At Hooulu Aina, vans line up to deliver food to families in need. More than 21% of Kalihi residents filed for unemployment by May.

Anita Hofschneider/Civil Beat

Megan Inada, a staffer at KKV, said the pandemic has upended traditional job titles and forced everyone at the clinic to shift jobs. Inadas official title is researcher now, she often spends mornings sifting through new data about positive coronavirus cases and fielding calls from patients.

At Hooulu Aina, a conference room morphed into a mini-headquarters for emergency planning and then a storage room stocked with food and water from Costco, Sams Club and local donors. The food deliveries are necessary as the Department of Health has struggled to help COVID-19 patients quickly and hunger needs have ballooned. Since June 19 KKV has delivered food to about 200 COVID-19 positive households, or more than an estimated 1,000 people.

A list of food that will be delivered families in Kalihi. At Hooulu Aina, a conference room has been transformed into a storage room for food to feed sick families in the pandemic.

Anita Hofschneider/Civil Beat

Across Kalihi, churches and community groups are mobilizing. Service providers at We Are Oceania are helping Pacific Islanders access health insurance and unemployment. Hawaii Cedar Church has been distributing food to homeless people. Every Saturday, Coronacare Hawaii has been giving out local produce in Kalihi.

Even advocates who normally dont live or work in Kalihi are responding to the need. David Tautofi is a Kaimuki High School football coach who grew up in Palolo public housing. He runs a youth development organization and has been partnering with other groups to deliver food.

On Friday, he went with volunteers from Altres, Ham Produce and Seafood and Chef Hui to Kuhio Park Terrace to give out milk, bread and other staples, but noticed that people seemed wary about picking it up. He thought perhaps because its the beginning of the month, people might have food stamps and need less food. But after talking to the group of advocates who helped with food distribution, he realized that wasnt the full story.

Were seeing firsthand the real fear of the COVID among Kalihi families especially those in the projects, he said.

He sensed that people wanted the food but were wary of picking it up, fearful of being in the elevator and getting close to strangers. Theyre thinking about doing door-to-door distribution when they go back Friday.

Theres not enough resources going to Kalihi, especially the housing projects throughout Honolulu and I just feel like theres not enough urgency for that, Tautofi said.

Shifting to meeting the needs of COVID-19 patients and other Kalihi families is fulfilling for many advocates. But it comes with emotional and physical costs.

Everyone is doing five different jobs, said Inada at KKV. The worst part of the 60-hour workweeks is not being able to spend time with her son.

By this point in the pandemic, some community health center staffers are getting sick, and are going home to crowded homes just like their patients. Many of them know someone who has died of the virus, according to Dr. David Derauf, executive director of KKV.

Megan Inada is a researcher at KKV but now spends her days helping to coordinate COVID-19 patients needs.

Anita Hofschneider/Civil Beat

But despite the challenges, he worries stories about Kalihis resiliency and generosity are being overlooked. One of his COVID-19 patients was recently on oxygen at home for several days. During his telehealth appointments with Derauf, rather than discussing his own problems, the patient mostly talked about wanting to make sure his wife and children were safe.

Kokua is always a two-way street, Derauf said. Its never about charity flowing from high to low.

Rona Mangayayam, youth services coordinator for KKV, recalls visiting Kalihi Valley Homes and giving several masks to a young man who recognized her from KVIBE. As the boy walked home, she saw him give the masks to a group of boys who werent wearing them.

He immediately opened the mask package and immediately went there and distributed to the young men, Mangayayam recalled. She heard him tell them, This is free, use it.

Another day, KKV staffers tried to give food to a homeless man. He replied he was OK, instead pointing out a woman who was hungry.

We are part of this community, Inada said. Everyone is holding each other up as we try to get through this pandemic.

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Kalihi Has The Worst COVID-19 Outbreak In Hawaii. Here's How The - Honolulu Civil Beat

A hairdresser by trade, she knew a diagnosis of Covid-19 would put her out of work for a month or more, despite all the careful safety precautions she'd been using to keep her clients safe.

"If I don't work I don't get paid," Minina said. "And if I'm quarantined at home, I would have to pay for food delivery, or I might be too sick to cook and have to pay for take-out, all of which I can't afford."

It wasn't the first time Minina, a single mom, had faced the financial and emotional stress that Covid-19 has brought into people's lives. At the beginning of the pandemic she was out of work for six weeks and had to skip two mortgage payments. The stress began to affect her health.

"I could feel my heart racing, palpitations that felt like a heart attack, but it was anxiety," Minina said. "I suffer from PTSD (post-traumatic stress disorder) and even with my medication, I was having panic attacks."

One-fourth of caregivers in worse health

Similar situations are occurring daily in homes across the United States as the added pressure of the pandemic takes its toll on our lives, according to a national analysis of at least 6.7 million caregivers insured by the Blue Cross Blue Shield Association.

The report, published Wednesday, found 26% of unpaid caregivers trying to balance work and family due to Covid-19 are feeling more stress and have poorer physical health than before the pandemic.

"Being a caregiver is lonely. And loneliness is a very real thing that has clinical implications," Drane added. "I think a bright spot of Covid-19 could be that it may help normalize the pervasiveness of this reality so that folks can feel less alone in it."

Millennials hit hardest

Millennial caregivers, the generation that is currently between the ages of 24 and 39, appear to be hardest hit when compared to a benchmark population, the analysis found.

Millennials were 82% more likely to have hypertension, had a 60% or higher increase in anxiety or major depression and a 74% increase in obesity, according to the data. They were also much more likely to visit emergency rooms (33%) or be hospitalized (59%).

That analysis found millennials were more likely to have hypertension, high cholesterol, Type 2 diabetes and major depression; and more likely to use tobacco, alcohol and have substance use disorders compared to the national population.

There is also a generational aspect to coping with the virus today that comes into play, Drane said.

"Because they're younger, they haven't seen things go bad such as boomers have," Drane said. "If you've lived through hard times before, you know you're going to survive the virus.

"The younger you are, the more overwhelming Covid-19 is feeling. And the data is playing that out," she added.

Mental health issues

Feeling overwhelmed is affecting more than physical health. The mental health of caregivers is also declining during the pandemic.

Some 57% of all caregivers reported clinically significant levels of stress, anxiety or depression and many are turning to unhealthy behaviors to cope, according to the 2020 Archangels National Caregiver Survey, a separate report done in collaboration with BCBS.

"The stress of caregiving is so real that people are coping with alcohol, coping with medication, and coping with food -- in fact 50% of all caregivers we surveyed had turned to food as a coping mechanism, compared to 14% who turned to alcohol and 18% who turned to medications," Drane said.

"It's hard to be a caregiver in the middle of the night if you have been drinking or taking drugs, and so a lot of caregivers turn to food," Drane added. "About 72% of Gen Z women are coping with food, and so are 53% of millennial men."

Socioeconomic differences

The report also found the health impact of caregiving is much larger in Black or Brown communities than those with a predominately white population.

Part of it is due to sheer numbers: The Archangel survey found 64% of caregivers in the Latinx communities and 57% in Black communities, while only 37% of caregivers were White.

Still, White caregivers were 56% more likely to suffer feelings of isolation or loneliness compared to 52% of Latinx caregivers and 43% of Black caregivers.

"There's a high prevalence of multi-generational households in these communities," Drane said. "And there's some wonderful components that because there's a strong community and that can lead to less anxiety, right?

"But there's also the additional stress of caring for someone in your home when you are an essential worker or the only provider of income, which sometimes overlaps with lower income situations," she added.

'It's exhausting'

Back in Georgia, Raquel Minina is breathing a sigh of relief. Syrus tested negative for Covid-19, and his symptoms improved within days, a sign that he was suffering from a cold or a tummy bug instead of Covid-19.

Another blessing: After petitioning the school district, she was able to convince officials to allow Syrus to attend virtual learning from home, instead of returning to school in person.

While that means she can continue to work, it doesn't reduce the additional stress Minina faces as she monitors his in-home schooling, a challenge facing many parents across the country.

"Syrus has dyslexia and ADD, and I have to be with him while he studies to be sure he stays focused," Minina said. "And because of his learning disabilities, it takes him longer to do his work. We're at it between six and eight hours a day.

"And when he's taking a break, I'm making lunch or dinner or prepping for his next class," she added. "It's exhausting. I just keep telling myself that it will be over -- once we get a vaccine, it will be over."

How to get help

If you are a caregiver, there are ways to cope and ease your stress, according to experts.

And remember, there are caregivers all around you who both need your help or could offer support or advice.

"There are caregivers everywhere, and they don't look like what you expect," Drane said. "They need you to stop and recognize their challenges, and they will recognize yours. Just connecting around a shared reality is a relief. Let that be your bright spot."

Read the original:

Parents and other caregivers are more stressed and in poorer health due to pandemic, report finds - CNN

Governor Tom Wolf and Secretary of Health Dr. Rachel Levine today released a weekly status update detailing the states mitigation efforts based on the COVID-19 Early Warning Monitoring System Dashboard. Updates are released each Monday.

The update includes the following:

The dashboard is designed to provide early warning signs of factors that affect the states mitigation efforts. The data available on the early warning monitoring dashboard includes week-over-week case differences, incidence rates, test percent-positivity, and rates of hospitalizations, ventilations and emergency room visits tied to COVID-19. This weeks update compares the period of August 28 September 3 to the previous seven days, August 21 August 27.

Our percent positivity increased significantly this week, a sign that this virus is still affecting Pennsylvanians, Gov. Wolf said. We must continue our focus on taking actions to protect ourselves and others, such as wearing a mask, practicing social distancing, washing our hands and avoiding large gatherings. Together, Pennsylvanians can work to prevent the spread of the virus.

As of Thursday, September 3, the state has seen a seven-day case increase of 5,453; the previous seven-day increase was 4,188, indicating a 1,265-case increase across the state over the past week.

The statewide percent-positivity went up to 4.0% from 3.2% last week. Counties with concerning percent-positivity include Columbia (18.9%), Armstrong (8.6%), York (7.9%), Clinton (7.4%), Beaver (6.4%), Northumberland (5.7%), Indiana (5.6%), Blair (5.2%), Centre (5.0%), Dauphin (5.0%), and Lancaster (5.0%). Each of these counties bears watching as the state continues to monitor all available data.

Community TransmissionAs of Fridays data, Columbia and Centre counties were in the substantial level with known sources of outbreaks fueling community transmission. The departments of Education and Health will speak with school district representatives in both counties to discuss the implications of this level of transmission.

For the week ending September 3, 20 counties were in the low level of transmission, 45 counties in the moderate level, with two at the substantial transmission level:

Cases Among 5-18-Year-OldsThe Department of Health is providing weekly data on the number of statewide cases of COVID-19 among 5-18-year-olds.

Throughout the pandemic, there have been 7,788 total cases of COVID-19 among 5-18-year-olds. Of that total, 486 occurred between August 28-September 3.

Cases by demographic can be found here.

Business VisitsThe Department of Health is providing weekly data on the number of individuals who responded to case investigators that they spent time at business establishments (restaurants, bars, gym/fitness centers, salon/barbershops) and at mass gatherings 14 days prior to the onset of COVID-19 symptoms.

Of the 4,442 confirmed cases reported between August 23 and August 29, 44 percent (1,953) provided an answer to the question as to whether they spent time at a business establishment.

Of those who did provide an answer, 13.5 percent, or 263, answered yes, they visited a business establishment 14 days prior to onset of symptoms:

Of the 4,442 confirmed cases, 45 percent (2,002) answered the question as to whether they attended a mass gathering or other large event. Of the 45 percent, nearly 14 percent (273) answered yes to whether they attended a mass gathering or other large event 14 days prior to onset of symptoms.

Compared to data reported on August 31, this weeks data saw an increase in people who reported visiting a restaurant (60 percent vs. 50 percent) and going to a gym/fitness center (14 percent vs. 12 percent). Numbers went down for this weeks data for people going to some other business (21 percent vs. 25 percent), going to a salon/barbershop (7 percent vs. 9 percent) and going to a bar (11 percent vs. 12 percent). The number of those who attended a mass gathering or other large event went up from nearly 13 percent to nearly 14 percent.

On July 13 contact tracers began asking more specific questions on the types of businesses visited and if individuals attended a mass gathering, defined as more than 250 people in attendance outdoors or more than 25 indoors.

The numbers above highlight business settings and mass gatherings as possible sites for transmission. With less than half of those asked about what types of businesses they visited or if they attended a mass gathering responding to the question, the department is reminding Pennsylvanians that it is essential that people answer the phone when case investigators call and to provide full and complete information to these clinical professionals.

Travel RecommendationsAlso today, the Department of Health updated its travel recommendations, originally announced on July 2, to remove California, and add North Carolina to the list of states recommended for domestic travelers returning from to quarantine for 14 days upon return to Pennsylvania.

It is important that people understand that this recommendation is in place to prevent the spread of COVID-19 in Pennsylvania. A concerning number of recent cases have been linked to travel, and if people are going to travel, we need them to take steps to protect themselves, their loved ones and their community, and that involves quarantining.

Gov. Wolf continues to prioritize the health and safety of all Pennsylvanians through the COVID-19 pandemic. Pennsylvanians should continue to take actions to prevent the spread of COVID-19, regardless of in what county they live. This includes wearing a mask or face covering anytime they are in public. COVID-19 has been shown to spread easily in the air and contagious carriers can be asymptomatic.

More:

Pennsylvania Shares Update on COVID-19 Early Warning Monitoring Dashboard, County Transmission Levels, Cases Traced to Businesses - pa.gov

You guys must be twiddling your thumbs these days, huh? This was the ill-informed question posed to me by one of our outpatient primary care doctors moonlighting as a hospitalist in this all-hands-on-deck time of ours. I looked at him and only laughed.

During the early stages of COVID-19 in my state of Massachusetts, we experienced frequent emergency department referrals of brief psychosis related to severe anxiety in the context of what was then COVID-19 anticipation.1 Now that we are in a full-blown surge, the 2 most striking pathologies we are seeing on the medical side are a much greater volume than usual of refractory delirium, both in COVID-19 and patients without-COVID-19, punctuated by less common but puzzling cases of persistent encephalopathy seemingly related to COVID-19 infection.

The biggest challenge we have faced thus far has been the requests for assistance in managing persistent delirium. These have increased about three-fold and continue to rise. The requests have been split roughly in half between patients with COVID-19 and those without COVID-19, mirroring where we are at this point with regard to inpatient populations, with actually only about a quarter having been intubated at some point in the ICU. Almost all the patients are older than 75, and about three-quarters are male. About three-quarters have pre-existing cognitive decline. About a quarter are non-native English speakers. Many have required significantly higher doses of antipsychotic medications than are typically prescribed. Most have required augmenting agents such as anti-epilepsy drugs, benzodiazepines, barbiturates, dexmedetomidine, opiates, and/or ketamine.

The question, of course, is why are these cases so refractory? Never in my experience have we had to resort to such trial and error, and really for the safety of the patients and staff, as many patients have been unwittingly violent.

We have collected the following contributors to this phenomenon:

1The hospital has not been allowing any visitors. There have been no family or other social supports at the bedside on a consistent basis to orient and reorient patients appropriately.

2Staff are required to wear masks at all times. On the medical and surgical floors, most are wearing much more, including all manner of goggles, face shields, and surgical caps. In other words, every person these patients see looks like something out of a science fiction movie. There are no faces to read and no way to gain a sense of the situation.

3There is no touch. I never noticed how much I touch older patients until now. We all catch ourselves as we instinctively reach to touch a shoulder, to hold a hand, to press someone back down gently into bed. None of this happens any more.

4 The lack of technological experience in the older population has made communication between patients and their spouses, siblings, and peers difficult. Many family members with whom we have spoken do not have smartphones or computers. This has also made applications for Medicaid and other assistance exceedingly slow and difficult to arrange.

5 Closure of the courts impacts care. Court closures have delayed cases of guardianship, thereby lengthening duration of hospital stays.

6 The language barrier complicates matters.Obviously, language issues make the experience that much more isolating.

7 Staff fatigue and burnout are evident. Both are playing a role in care, as there seems to be little patience for agitation and confusion. The immediate requests for assistance are invariably for sedating medications.

8 Bottlenecking on discharge continues to be a problem. With the COVID-19 crisis, there have been very few available skilled nursing facilities and long-term care facilities for patients. This also results in much longer hospital stays.

Persistent encephalopathy, although much less common than the delirium, has been more difficult to explain and thus far unresponsive to all attempted treatments. The 5 cases we have seen were aptly described by an ICU team as different than the typical different we have been seeing. (This piece explores the 2 earliest cases, but all cases have been similar.) In the 2 earliest cases, the patients were admitted for COVID-19 infection with subsequent complications. One patient was female in her late 50s, and the other was male in his early 60s. Both patients had significant psychiatric histories with previous psychotic symptoms and had been on longstanding chronic antipsychotic medications. The patients were both intubated during their respective hospital courses3 days for our female patient and 3 weeks for our male patientand both required tracheostomy due to complications. Both had type 2 diabetes, hypertension, and chronic obstructive pulmonary disease, and both were smokers. They both had been living in skilled nursing facilities and had previous strokes. The patients had remote substance use history, having used alcohol and cannabis. At baseline, prior to their hospitalizations, both had been fully cognizant and conversant as well as fully ambulatory with only minimal motor deficits.

The differences in their behavior were noted soon after extubation. As their pulmonary function improved and organs generally recovered, they remained mentally altered, mostly staring off and non-interactive. The patients appeared conscious and awake, but they would not eat or drink on their own nor would they respond to any commands. Their pupils were sluggish but reactive, but their eyes could not track. They had intermittent episodes of rigidity, mostly in their upper extremities and neck. The differential included stroke, status epilepticus, catatonia, hypoactive delirium, and neuroleptic malignant syndrome (their antipsychotic medications had been discontinued abruptly in the setting of treatment with hydroxychloroquine and azithromycin due to risk of QTc prolongation). Inflammatory markers were persistently elevated, consistent with COVID-19 infection as well as neuroleptic malignant syndrome. Vital signs were unremarkable.

Stroke and seizure were ruled out. Further infectious causes were ruled out. Metabolic causes were ruled out. Antipsychotics were held, and empiric treatment with lorazepam and bromocriptine were initiated. Some improvement was noted in rigidity, but nothing else. Gradual reintroduction of antipsychotics had no effect. Inflammatory markers stabilized, but there was no improvement in mental status. Both patients are still with us, but they are vegetative, on total parenteral nutrition, now total care, and are awaiting long-term care placement.

At this point the differential includes anoxic brain injury due to complicated intubation, chronic delirium, or direct neurotoxic effect of the COVID-19 virus on the brain. There are similar case reports, but presently these cases remain a mystery.2,3

Other issues with which the psychiatry consultation-liaison service is contending are the management of acute substance withdrawals in critically ill patients with COVID-19 (often mimicking symptoms of the illness itself), collaborating with our palliative care colleagues in determining the futility of care, and the management and placement of patients who are psychiatrically decompensated and COVID-19-positive (but asymptomatic) for whom there are very few placement options.

We are not exactly twiddling our thumbs. In my particular hospital, we have been working inspiringly, tirelessly, and exceedingly well together throughout this crisis.

Dr Martin is director of medical psychiatry, Newton-Wellesley Hospital, Newton, MA, and clinical assistant professor of psychiatry at Tufts University School of Medicine, Boston.

References

1. Martin Jr EB. Brief psychotic disorder triggered by fear of coronavirus? Psychiatric Times. May 8, 2020; Epub ahead of print. https://www.psychiatrictimes.com/coronavirus/brief-psychotic-disorder-triggered-fear-coronavirus-small-case-series

2. McNamara D. Neurologic symptoms and COVID-19: whats known, what isnt. The Hospitalist. April 6, 2020. Accessed August 10, 2020. https://www.the-hospitalist.org/hospitalist/article/220289/coronavirus-updates/neurologic-symptoms-and-covid-19-whats-known-what

3. Wu Y, Xu X, Chen Z, et al. Nervous system involvement after infection with COVID-19 and other coronaviruses. Brain Behav Immun. March 30, 2020; Epub ahead of print.

Read more from the original source:

Delirium, Encephalopathy, and COVID-19: An Update From the Field - Psychiatric Times

Four additional states have been added to Connecticuts list of COVID-19 hotspots and two territories have been removed.

On Tuesday, the State of Connecticut updated its travel advisory and the list of states considered COVID-19 hotspots.

Delaware, Maryland, Ohio and West Virginia were added to the list while Puerto Rico and the Virgin Islands were removed.

Anyone traveling to Connecticut from any of the areas on the list or Connecticut residents traveling home from these areas must quarantine for two weeks.and complete theTravel Health Formif they have spent 24 four hours or more in an state on the list within 14 days of arriving in Connecticut.It does not apply for anyone who will be in Connecticut for less than 24 hours. (See the frequently asked questions below for more information.)

The governors of Connecticut, New York and New Jersey enacted a travel advisory order with a quarantine requirement at the end of June to help slow the spread of COVID-19 in the region and keep infection rates low in the region.

The travel advisory is updated on a weekly basis to include states and territories with a positive test rate higher than 10 per 100,000 residents, or higher than 10 percent over a week.

These were the COVID-19 hotspots on the list last week:

(The frequently asked questions are from the state's website.)

Originally posted here:

4 More States Added to Conn. Travel Advisory of COVID-19 Hotspots, 2 Territories Removed - NBC Connecticut

Carson City Health and Human Services

Carson City Health and Human Services is reporting Tuesday, Sept. 8, 2020 that there are nine new cases and 15 additional recoveries of COVID-19 in the Quad-County region. This brings the total number of cases to 1,100, with 989 recoveries and 15 deaths, 96 cases remain active.

The new cases are: A male Carson City resident in his 60s with no connection to a previously reported case.

Carson City Health and Human Services is working to identify close risk contacts to prevent further spread of the disease. Due to medical privacy requirements and to protect their identity, no further information about the cases will be released.

Carson City-465 Total Cases (+6 from 9/7)-42 Active (+3 from 9/7)-415 Recovered (+3 from 9/7)-8 Deaths (+0 from 9/7)

Douglas County-261 Total (+0 from 9/7)-8 Active (-3 from 9/7)-252 Recovered (+3 from 9/7)-1 Death (+0 from 9/7)

Lyon County-365 Total (+3 from 9/7)-44 Active (-6 from 9/7)-315 Recovered (+9 from 9/7)- 6 Deaths (+0 from 9/7)

Storey County-9 Total (+0 from 9/7)-2 Active (+0 from 9/7)-7 Recoveries (+0 from 9/7)

TOTAL-1100 Total Cases (+9 from 9/7)-96 Active (-6 from 9/7)-989 Recovered (+15 from 9/7)-15 Deaths (+0 from 9/7)

Gender and age break down of the cases by county as well as the cases by zip code is available at https://gethealthycarsoncity.org/novel-coronavirus-2019/

Statewide numbers can be found at the Nevada Health Response website: https://nvhealthresponse.nv.gov

Drive-Thru COVID-19 Testing for Quad-County Residents There is one more drive-thru COVID-19 testing event for Quad-County residents next week. Testing is free of charge; first come, first served, no appointments or reservations.

Sept. 11, 4 p.m. to 6 p.m. East Fork Fire Station 12 (3620 N. Sunridge Dr, Carson City)

For those who are experiencing symptoms of COVID-19 or have questions, call the Quad-County COVID-19 Hotline Monday through Friday, 8:30 am to 4:30 pm. Spanish speakers are available. The phone number is (775) 283-4789.

View original post here:

Carson City, Quad county COVID-19 Tuesday briefing: 9 new cases and 15 recoveries - Carson Now

This week is the marker for six months of COVID-19 in Michigan.

The first cases announced on March 10th, nothing has been the same since.

I found myself saying, Weve never lived through anything like this, and I feel like Ive said that time after time after again, says Governor Gretchen Whitmer.

Michigan has been through a lot in the past half year as it fought against COVID-19.

Starting as one of the hardest hit states, Michigan has rebounded and is leading the way to recovery.

That came with a lot of decisions made by Gov. Whitmer. The hardest she says was closing schools.

That was a tough decision, she says, It weighed heavily on me.

The most difficult fight? The pushback on mask wearing.

If we could get the politics out of simple actions like that.

And the criticism.

Closing down sectors of the economy, controversial nursing home strategies and budget cuts, many not popular but Whitmer stands by the science at the time.

If I could go on a time machine with the knowledge that I have today, says Whitmer, Would we make different decisions? Of course.

Thats the biggest thing, how much the fight has changed as they learn more.

Do you think about the incredible amount of knowledge that we have gotten about this virus in the last six months? says Whitmer, We know a lot more but there still a lot to learn though.

The biggest will be a vaccine, the only way out of this pandemic according the Whitmer.

Thats a very compressed timeline, says Whitmer, Ordinarily its a five-year process and if in the next six months there is a number of approved vaccines and they can start ramping up? That would be great.

With it, will come new challenges, like people willing to take a vaccine. Already many saying they wont.

Were going to have to give the public assurances, says Whitmer, Im going to want to know, before I take a vaccine, that there is some efficacy that is safe.

Originally posted here:

Whitmer Recaps the Impact of Six Months of COVID-19 - 9 & 10 News - 9&10 News

The official name for my new heart troubles, as Ive recently been diagnosed, is postural orthostatic tachycardia syndrome, or POTS. The condition, a puzzling dysfunction of both the heart and the nervous system, messes with how the body regulates involuntary functions, including pulse. POTS is known to affect approximately 500,000 people in the U.S., typically young women in their late teens or early 20s. But now, several cardiologists with whom Ive spoken say theyre noticing an unsettling trend. Previously fit and healthy women of all ages who have had COVID-19 are showing up at their offices, complaining of inexplicably racing hearts.

Read: COVID-19 can last for several months.

The more we learn about COVID-19, the stranger its effects appear to be. Beyond its telltale fever and cough, troubling early evidence has been mounting that the disease can damage many organs in the body, including the lungs, the brain, andyes, you guessed itthe heart. An array of cardiac dysfunctions has cropped up, confounding researchers and revealing that COVID-19 is a far more complicated and potentially long-lasting disease than people initially expected. These heart ailments have especially gained attention from sports: Some college football players who have had COVID-19 are sitting out this season with myocarditis, a rare condition that can be fatal if untreated. The Red Sox pitcher Eduardo Rodriguez is doing the same.

In a strange way, I feel lucky. POTS is not life-threateningat least, aside from the risk of head trauma from blacking out. But it is destabilizing, both physically and mentally, to wander around not knowing what my body has in store for me from one minute to the next. Like so many other aspects of this pandemic, this latest syndrome in my parade of illness is mysterious, disruptive, and scarily indefinite.

After my smoothie incident, I called my cousin Emily Wessler, a pediatric cardiologist at Stanford, and asked her what was going on in my body whenever I felt like I was going to pass out. Youre not getting enough blood to the brain, she told me, so the brain says, Shut down! Shut down! Emergency! Shed been reading more and more professional chatter about cases of POTS and other cardiovascular disorders post-COVID, so she urged me to make an appointment with a cardiologist. She added that I also might want to speak with a neurologist. There are a lot of doctors to call if your whole body feels like its malfunctioning, which is not ideal at a time when millions of Americans are losing their health insurance.

I started with a cardiologist. At NYU Langone, Seol Young Han Hwang hooked me up to an EKG that immediately spit out bad news. Sinus tachycardia, it read. Abnormal ECG. In other words, my heart was beating much faster than it should have been, given that I was reclining on an exam table. Han asked me to wear a Holter monitor for a week to trace my hearts vagaries. It showed abrupt daily spikes, during which my heart rate would jump from as low as 51 beats per minute, while at rest, to as high as 163.

Read the original here:

COVID-19 Heart Problems: What Is the Pandemic Doing to Us? - The Atlantic

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Coronavirus is a family of viruses that can cause respiratory illnesses such as the common cold, severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS).

Coronaviruses are a family of viruses that can cause illnesses such as the common cold, severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). In 2019, a new coronavirus was identified as the cause of a disease outbreak that originated in China.

The virus is now known as the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease it causes is called coronavirus disease 2019 (COVID-19). In March 2020, the World Health Organization (WHO) declared the COVID-19 outbreak a pandemic.

Public health groups, including the U.S. Centers for Disease Control and Prevention (CDC) and WHO, are monitoring the pandemic and posting updates on their websites. These groups have also issued recommendations for preventing and treating the illness.

Signs and symptoms of coronavirus disease 2019 (COVID-19) may appear two to 14 days after exposure. This time after exposure and before having symptoms is called the incubation period. Common signs and symptoms can include:

Early symptoms of COVID-19 may include a loss of taste or smell.

Other symptoms can include:

This list is not all inclusive. Other less common symptoms have been reported, such as rash, nausea, vomiting and diarrhea. Children have similar symptoms to adults and generally have mild illness.

The severity of COVID-19 symptoms can range from very mild to severe. Some people may have only a few symptoms, and some people may have no symptoms at all. Some people may experience worsened symptoms, such as worsened shortness of breath and pneumonia, about a week after symptoms start.

People who are older have a higher risk of serious illness from COVID-19, and the risk increases with age. People who have existing chronic medical conditions also may have a higher risk of serious illness. Serious medical conditions that increase the risk of serious illness from COVID-19 include:

Other conditions may increase the risk of serious illness, such as:

This list is not all inclusive. Other underlying medical conditions may increase your risk of serious illness from COVID-19.

If you have COVID-19 symptoms or you've been in contact with someone diagnosed with COVID-19, contact your doctor or clinic right away for medical advice. Tell your health care team about your symptoms and possible exposure before you go to your appointment.

If you have emergency COVID-19 signs and symptoms, seek care immediately. Emergency signs and symptoms can include:

If you have signs or symptoms of COVID-19, contact your doctor or clinic for guidance. Let your doctor know if you have other chronic medical conditions, such as heart disease or lung disease. During the pandemic, it's important to make sure health care is available for those in greatest need.

Infection with the new coronavirus (severe acute respiratory syndrome coronavirus 2, or SARS-CoV-2) causes coronavirus disease 2019 (COVID-19).

The virus appears to spread easily among people, and more continues to be discovered over time about how it spreads. Data has shown that it spreads from person to person among those in close contact (within about 6 feet, or 2 meters). The virus spreads by respiratory droplets released when someone with the virus coughs, sneezes or talks. These droplets can be inhaled or land in the mouth or nose of a person nearby.

It can also spread if a person touches a surface with the virus on it and then touches his or her mouth, nose or eyes, although this isn't considered to be a main way it spreads.

Risk factors for COVID-19 appear to include:

Although most people with COVID-19 have mild to moderate symptoms, the disease can cause severe medical complications and lead to death in some people. Older adults or people with existing chronic medical conditions are at greater risk of becoming seriously ill with COVID-19.

Complications can include:

Although there is no vaccine available to prevent COVID-19, you can take steps to reduce your risk of infection. WHO and CDC recommend following these precautions for avoiding COVID-19:

If you have a chronic medical condition and may have a higher risk of serious illness, check with your doctor about other ways to protect yourself.

If you're planning to travel, first check the CDC and WHO websites for updates and advice. Also look for any health advisories that may be in place where you plan to travel. You may also want to talk with your doctor if you have health conditions that make you more susceptible to respiratory infections and complications.

Aug. 07, 2020

Here is the original post:

Coronavirus disease 2019 (COVID-19) - Symptoms and causes ...

A doctor wearing a face mask looks at a CT image of a lung of a patient at a hospital in Wuhan, China. AFP via Getty Images hide caption

A doctor wearing a face mask looks at a CT image of a lung of a patient at a hospital in Wuhan, China.

Updated on March 17 at 6:43 p.m. ET:

Thousands of people have now died from COVID-19 the name for the disease caused by the coronavirus first identified in Wuhan, China.

According to the World Health Organization, the disease is relatively mild in about 80% of cases.

What does mild mean?

And how does this disease turn fatal?

The first symptoms of COVID-19 are pretty common with respiratory illnesses fever, a dry cough and shortness of breath, says Dr. Carlos del Rio, a professor of medicine and global health at Emory University who has consulted with colleagues treating coronavirus patients in China and Germany. "Some people also get a headache, sore throat," he says. Fatigue has also been reported and less commonly, diarrhea. It may feel as if you have a cold. Or you may feel that flu-like feeling of being hit by a train.

Doctors say these patients with milder symptoms should check in with their physician to make sure their symptoms don't progress to something more serious, but they don't require major medical intervention.

But the new coronavirus attacks the lungs, and in about 20% of patients, infections can get more serious. As the virus enters lung cells, it starts to replicate, destroying the cells, explains Dr. Yoko Furuya, an infectious disease specialist at Columbia University Irving Medical Center.

"Because our body senses all of those viruses as basically foreign invaders, that triggers our immune system to sweep in and try to contain and control the virus and stop it from making more and more copies of itself," she says.

But Furuya says that this immune system response to this invader can also destroy lung tissue and cause inflammation. The end result can be pneumonia. That means the air sacs in the lungs become inflamed and filled with fluid, making it harder to breathe.

Del Rio says that these symptoms can also make it harder for the lungs to get oxygen to your blood, potentially triggering a cascade of problems. "The lack of oxygen leads to more inflammation, more problems in the body. Organs need oxygen to function, right? So when you don't have oxygen there, then your liver dies and your kidney dies," he says. Lack of oxygen can also lead to septic shock.

The most severe cases about 6% of patients end up in intensive care with multi-organ failure, respiratory failure and septic shock, according to a February report from the WHO. And many hospitalized patients require supplemental oxygen. In extreme cases, they need mechanical ventilation including the use of a sophisticated technology known as ECMO (extracorporeal membrane oxygenation), which basically acts as the patient's lungs, adding oxygen to their blood and removing carbon dioxide. The technology "allows us to save more severe patients," Dr. Sylvie Briand, director of the WHO's pandemic and epidemic diseases department, said at a press conference In February.

Many of the more serious cases have been in people who are middle-aged and elderly Furuya notes that our immune system gets weaker as we age. She says for long-term smokers, it could be even worse because their airways and lungs are more vulnerable. People with other underlying medical conditions, such as heart disease, diabetes or chronic lung disease, have also proved most vulnerable. Furuya says those kinds of conditions can make it harder for the body to recover from infections.

"Of course, you have outliers people who are young and otherwise previously healthy who are dying," Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told NPR's 1A show. "But if you look at the vast majority of the people who have serious disease and who will ultimately die, they are in that group that are either elderly and/or have underlying conditions."

Estimates for the case fatality rate for COVID-19 vary depending on the country. But data from both China and Lombardy, Italy, show the fatality rate starts rising for people in their 60s. In Lombardy, for instance, the case fatality rate for those in their 60s is nearly 3 percent. It's nearly 10 percent for people in their 70s and more than 16 percent for those in their 80s.

Del Rio notes that it's not just COVID-19 that can bring on multi-organ failure. Just last month, he saw the same thing in a previously healthy flu patient in the U.S. who had not gotten a flu shot.

"He went in to a doctor. They said, 'You have the flu don't worry.' He went home. Two days later, he was in the ER. Five days later, he was very sick and in the ICU" with organ failure, del Rio says. While it's possible for patients who reach this stage to survive, recovery can take many weeks or months.

In fact, many infectious disease experts have been making comparisons between this new coronavirus and the flu and common cold, because it appears to be highly transmissible.

"What this is acting like it's spreading much more rapidly than SARS [severe acute respiratory syndrome], the other coronavirus, but the fatality rate is much less," Fauci told 1A. "It's acting much more like a really bad influenza."

What experts fear is that, like the flu, COVID-19 will keep coming back year after year. But unlike the flu, there is no vaccine yet for the coronavirus disease.

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How Patients Die After Contracting COVID-19, The New ...

The West Virginia Department of Health andHuman Resources (DHHR) reports as of 10:00 a.m., on August 10,2020, there have been 326,886 total confirmatorylaboratory results received for COVID-19, with 7,754 totalcases and 141 deaths.

DHHR has confirmed the deaths of an83-year old male from Kanawha County and a 74-year old male from Logan County. Wemourn with all families suffering the loss of loved ones due to COVID-19, saidBill J. Crouch, DHHR Cabinet Secretary.

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

CASESPER COUNTY (Case confirmed by lab test/Probable case):Barbour (29/0), Berkeley (671/27), Boone(101/0), Braxton (8/0), Brooke (63/1), Cabell (395/9), Calhoun (6/0), Clay(18/0), Doddridge (6/0), Fayette (151/0), Gilmer (17/0), Grant (120/1),Greenbrier (93/0), Hampshire (76/0), Hancock (108/4), Hardy (60/1), Harrison(223/3), Jackson (165/0), Jefferson (289/7), Kanawha (925/13), Lewis (28/1),Lincoln (87/0), Logan (234/0), Marion (187/4), Marshall (126/4), Mason (56/0),McDowell (63/1), Mercer (200/0), Mineral (121/2), Mingo (171/2), Monongalia(928/17), Monroe (20/1), Morgan (28/1), Nicholas (36/1), Ohio (266/3), Pendleton(40/1), Pleasants (11/1), Pocahontas (40/1), Preston (104/21), Putnam (194/1),Raleigh (248/7), Randolph (205/5), Ritchie (3/0), Roane (15/0), Summers (12/0),Taylor (55/1), Tucker (10/0), Tyler (13/0), Upshur (37/3), Wayne (208/2),Webster (4/0), Wetzel (43/0), Wirt (7/0), Wood (238/12), Wyoming (34/0).

Ascase surveillance continues at the local health department level, it may revealthat those tested in a certain county may not be a resident of that county, oreven the state as an individual in question may have crossed the state borderto be tested. Suchis the case of Marshall and Pleasants counties in this report.

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

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

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COVID-19 Daily Update 8-10-2020 - West Virginia Department of Health and Human Resources

The good news: The United States has a window of opportunity to beat back Covid-19 before things get much, much worse.

The bad news: That window is rapidly closing. And the country seems unwilling or unable to seize the moment.

Winter is coming. Winter means cold and flu season, which is all but sure to complicate the task of figuring out who is sick with Covid-19 and who is suffering from a less threatening respiratory tract infection. It also means that cherished outdoor freedoms that link us to pre-Covid life pop-up restaurant patios, picnics in parks, trips to the beach will soon be out of reach, at least in northern parts of the country.

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Unless Americans use the dwindling weeks between now and the onset of indoor weather to tamp down transmission in the country, this winter could be Dickensianly bleak, public health experts warn.

I think November, December, January, February are going to be tough months in this country without a vaccine, said Michael Osterholm, director of the Center for Infectious Diseases Research and Policy at the University of Minnesota.

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It is possible, of course, that some vaccines could be approved by then, thanks to historically rapid scientific work. But there is little prospect that vast numbers of Americans will be vaccinated in time to forestall the grim winter Osterholm and others foresee.

Human coronaviruses, the distant cold-causing cousins of the virus that causes Covid-19, circulate year-round. Now is typically the low season for transmission. But in this summer of Americas failed Covid-19 response, the SARS-CoV-2 virus is widespread across the country, and pandemic-weary Americans seem more interested in resuming pre-Covid lifestyles than in suppressing the virus to the point where schools can be reopened, and stay open, and restaurants, movie theaters, and gyms can function with some restrictions.

We should be aiming for no transmission before we open the schools and we put kids in harms way kids and teachers and their caregivers. And so, if that means no gym, no movie theaters, so be it, said Caroline Buckee, associate director of theCenter for Communicable Disease Dynamics at Harvards T.H. Chan School of Public Health.

We seem to be choosing leisure activities now over childrens safety in a months time. And I cannot understand that tradeoff.

While many countries managed to suppress spread of SARS-CoV-2, the United States has failed miserably. Countries in Europe and Asia are worrying about a second wave. Here, the first wave rages on, engulfing rural as well as urban parts of the country. Though theres been a slight decline in cases in the past couple of weeks, more than 50,000 Americans a day are being diagnosed with Covid-19. And those are just the confirmed cases.

To put that in perspective, at this rate the U.S. is racking up more cases in a week than Britain has accumulated since the start of the pandemic.

Public health officials had hoped transmission of the virus would abate with the warm temperatures of summer and the tendency heightened this year of people to take their recreational activities outdoors. Experts do believe people are less likely to transmit the virus outside, especially if they are wearing face coverings and keeping a safe distance apart.

But in some places, people have been throwing Covid cautions to the wind, flouting public health orders in the process. Kristen Ehresmann, director of infectious disease epidemiology, prevention, and control for the Minnesota Department of Health, points to a large, three-day rodeo that was held recently in her state. Organizers knew they were supposed to limit the number of attendees to 250 but refused; thousands attended. In Sturgis, S.D., an estimated quarter of a million motorcyclists were expected to descend on the city this past weekend for an annual rally that spans 10 days.

Even on smaller scales, public health authorities know some people are letting down their guard. Others have never embraced the need to try to prevent spread of the virus. Ehresmanns father was recently invited to visit some friends; he went, she said, but wore his mask, elbow bumping instead of shaking proffered hands. And the people kind of acted like, Oh, you drank that Kool-Aid, rather than, We all need to be doing this.'

Ehresmann and others in public health are flummoxed by the phenomenon of people refusing to acknowledge the risk the virus poses.

Just this idea of, I just dont want to believe it so therefore its not going to be true honestly, I have not really dealt with that as it relates to disease before, she said.

Buckee, the Harvard expert, wonders if the magical thinking that seems to have infected swaths of the country is due to the fact many of the people who have died were elderly. For many Americans, she said, the disease has not yet touched their lives but the movement restrictions and other response measures have.

I think if children were dying, this would be a different situation, quite honestly, she said.

Epidemiologist Michael Mina despairs that an important chance to wrestle the virus under control is being lost, as Americans ignore the realities of the pandemic in favor of trying to resume pre-Covid life.

We just continue to squander every bit of opportunity we get with this epidemic to get it under control, said Mina, an assistant professor in Harvards T.H. Chan School of Public Health and associate medical director of clinical microbiology at Bostons Brigham and Womens Hospital.

The best time to squash a pandemic is when the environmental characteristics slow transmission. Its your one opportunity in the year, really, to leverage that extra assistance and get transmission under control, he said, his frustration audible.

Driving back transmission would require people to continue to make sacrifices, to accept the fact that life post-Covid cannot proceed as normal, not while so many people remain vulnerable to the virus. Instead, people are giddily throwing off the shackles of coronavirus suppression efforts, seemingly convinced that a few weeks of sacrifice during the spring was a one-time solution.

Osterholm has for months warned that people were being misled about how long the restrictions on daily life would need to be in place. He now thinks the time has come for another lockdown. What we did before and more, he said.

The country has fallen into a dangerous pattern, Osterholm said, where a spike in cases in a location leads to some temporary restraint from people who eventually become alarmed enough to start to take precautions. But as soon as cases start to plateau or decline a little, victory over the virus is declared and people think its safe to resume normal life.

Its like an all or nothing phenomenon, right? said Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases. You all locked down or you get so discouraged with being lockdown that you decide youre going to be in crowded bars you can have indoor parties with no masks. You can do all the things that are going to get you in trouble.

Osterholm said with the K-12 school year resuming in some parts of the country or set to start along with universities in a few weeks, transmission will take off and cases will start to climb again. He predicted the next peaks will exceed by far the peak we have just experienced. Winter is only going to reinforce that. Indoor air, he said.

Buckee thinks that if the country doesnt alter the trajectory it is on, more shutdowns are inevitable. I cant see a way that were going to have restaurants and bars open in the winter, frankly. Well have resurgence. Everything will get shut down again.

Fauci favors a reset of the reopening measures, with a strong messaging component aimed at explaining to people why driving down transmission now will pay off later. Young people in particular need to understand that even if they are less likely to die from Covid-19, statistically speaking, transmission among 20-somethings will eventually lead to infections among their parents and grandparents, where the risk of severe infections and fatal outcomes is higher. (Young people can also develop long-term health problems as a result of the virus.)

Its not them alone in a vacuum, Fauci said. They are spreading it to the people who are going to wind up in the hospital.

Everyone has to work together to get cases down to more manageable levels, if the country hopes to avoid a disastrous winter, he said.

I think we can get it under much better control, between now and the mid-to-late fall when we get influenza or we get whatever it is we get in the fall and the winter. Im not giving up, said Fauci.

But without an all-in effort the cases are not going to come down, he warned. Theyre not. Theyre just not.

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America's window of opportunity to beat back Covid-19 is closing - STAT

The researchers found a 40% increase in child coronavirus cases in the states and cities that were studied during those two weeks.

The age range for children differed by state, with some defining children as only those up to age 14 and one state -- Alabama -- pushing the limit to 24.

While more classrooms are scheduled to reopen this week, some students who just started the school year must go back to virtual learning because of new infections among students and teachers.

Florida schools will reopen despite CDC guidance

But schools in at least 12 Florida counties will reopen this week for in-person learning, according to the Florida Education Association and school district websites.

Last month, the director of the Centers for Disease Control and Prevention said officials in counties where the test positivity rate is higher than 5% might consider keeping classrooms closed to students.

Yet out of those 12 counties where schools will reopen this week, at least nine had test positivity rates higher than 5% as of Saturday, according to the Florida Department of Health.

Students who returned to school must stay home again

North Paulding High School in Georgia made headlines after a student posted a photo of a packed hallway, with virtually no one appearing to wear a mask.

At least "six students and three staff members who were in school for at least some time last week ... have since reported to us that they have tested positive," Principal Gabe Carmona wrote in a letter to parents.

"We could have just delayed opening like many other schools," she said. "They kind of sent us to school and used us as guinea pigs to see what would happen later on."

The Cherokee County School District in Georgia said 19 students and four teachers or staff members have tested positive for since the start of the school year one week ago.

At least 16 schools across the county are impacted, the district said. Students and teachers affected must quarantine for two weeks.

'This is all wholly preventable'

Yet many Americans still aren't heeding the basic advice that would significantly reduce the spread -- and would help get more students back into classrooms safely, doctors say.

Why the CDC wants you to wear a mask

"We're still generating 50,000 to 70,000 new cases a day, 1,000 Americans are dying every day," said Dr. Ashish Jha, director of the Harvard Global Health Institute. "This is all wholly preventable."

Nationwide, 299 deaths were reported on July 5. On August 5, that number had jumped to 1,372. And for five days in a row last week, more than 1,000 Americans died each day.

'No way' for a vaccine by November

"I don't see how that would be possible," said Dr. Paul Offit, a vaccinologist at Children's Hospital of Philadelphia.

After that, researchers have to wait to see who gets sick with Covid-19, and who doesn't. Some volunteers will be getting a placebo instead of an actual vaccine.

Health officials have tied a resurgence in new cases to social gatherings among younger people, who can pass the virus to vulnerable populations.

Dr. Anthony Fauci had a message for those who might not take safety measures seriously: "Don't be the weak link in the chain."

"That's the message we've got to get to young people," he said during a webinar with the Alliance for Health Policy. "Obviously they're not doing anything deliberately and maliciously, but what they're doing is inadvertently -- they're propagating the outbreak."

And many Americans are now moving around as much as they did before the pandemic, said Dr. Christopher Murray, director of the Institute for Health Metrics and Evaluation at the University of Washington.

"If you look at the mobility data collected from cell phones in many parts of the country, we're almost back to pre-Covid levels of mobility," Murray said. "So we're just not being as cautious as other people are in other countries."

Originally posted here:

97,000 children tested positive for Covid-19 in 2 weeks as more schools plan to reopen - CNN

While many people with COVID-19 get over it relatively quickly, Marjorie Roberts has been living with symptoms for months. Marjorie Roberts hide caption

While many people with COVID-19 get over it relatively quickly, Marjorie Roberts has been living with symptoms for months.

For Marjorie Roberts, it started on March 26.

The healthy, 59-year-old life coach in Atlanta says it started as a normal day. She went out to get the mail. As she walked back to her apartment, she lost her balance. Odd for her, but she didn't think much of it.

By evening, "everything came down on me like a ton of bricks," she says. Extreme fatigue was the first symptom among several. Her long ordeal was just beginning. "I had no idea what I was in for."

On April 23, Natalie Nowell, 34, had a similar experience. A mom of three in Memphis, Tenn., she spent most of her time running around after her children. Her family had been quarantined for over a month.

Natalie Nowell with her husband and three children. She's been suffering from COVID-19 symptoms for months and still has trouble breathing. Ashley Veneman/Javen Photography hide caption

Natalie Nowell with her husband and three children. She's been suffering from COVID-19 symptoms for months and still has trouble breathing.

Then, seemingly out of nowhere came a heaviness in her chest and a feeling of deep unease. She told her husband she needed to rest. It was worse when she woke up. Awful chest pains "like there was a ton of bricks sitting on my chest," she says.

According to reports earlier this year from the World Health Organization, about 80% of coronavirus infections are "mild or asymptomatic" and patients typically recover after just two weeks.

That hasn't been the case for Roberts or Nowell. Months later, both women are still experiencing symptoms of COVID-19: shortness of breath, chest pains, vomiting, and neurological symptoms that range from headaches and fatigue to hallucinations and jumbled words.

Support groups on Facebook include thousands of people who say they have been wrestling with serious COVID-19 symptoms for at least a month, if not two or three. The groups have coined a name for themselves: "long-haulers."

While both Nowell and Roberts visited the emergency room early in the course of their illnesses, neither was admitted to an ICU. Doctors determined neither of them needed a ventilator; their cases technically counted as "mild."

But their lives have been irrevocably changed by the onslaught of symptoms relentless and rolling waves of fever, headache, nausea, and the terrifying inability to catch their breath. For Roberts, it's robbed her of time. "I was so good. This COVID-19 has stolen my life," she says.

Weeks after her initial symptoms, Nowell could barely walk from room to room in her house. Roberts, too, struggled to breathe.

Long-haulers are often left out of the COVID-19 narrative. Data sheets count cases, hospitalizations, recoveries and deaths, but Roberts and Nowell don't fit neatly into any of these categories. Neither woman initially tested positive for the disease. They both went to the hospital for a test when their symptoms became too much to bear, both tested negative, both were told to go home and just rest. Both women dealt with doctors who didn't believe them until finally both got confirmation they did have the virus.

Many long-haulers say their doctors doubted their symptoms were as severe as they were saying. Roberts says her original primary care physician insisted it was just stress and suggested she watch Lifetime movies and do puzzles to calm down. "I know stress," Roberts says. "This was not stress."

Nowell, who at that point couldn't form words to read bedtime stories to her children, begged her doctor to help. "He said, 'Well, maybe you have a UTI. Or maybe it's a stomach infection. Let's call it a sinus infection.' "

Both women eventually found doctors who believed them, and that made a huge difference.

"I was relieved because I felt like I was going to get taken seriously for how sick I felt," Nowell says. "And then the other part of me was terrified. Because the whole world is dealing with this, and now all of a sudden it's in my home, it's in my body and that was scary."

That was a few months ago. More than a hundred days from their first symptoms, Roberts and Nowell still struggle to breathe through constant congestion. The headaches come and go, and so does the nausea. Roberts' lungs are so scarred she had a biopsy in early August to get a better picture of her prognosis. She's still waiting for the results.

Nowell says she's doing better, but it's been slow going.

The heartbreaking loneliness of the pandemic has been difficult enough for healthy people. But it's been a terrifying challenge for those like Roberts and Nowell who also must live with foggy minds, intense fatigue and continual fear of erratic symptoms. Roberts says she's still afraid to go anywhere because the worst symptoms still come on so fast.

They both get through the day with a mixture of hope and prayer. Nowell has Bible verses she relies on. And Roberts says, "I pray they find a cure."

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What It's Like When COVID-19 Lasts For Months - NPR