Solidarity is key to organized labor and the revival of community – National Catholic Reporter

Solidarity. The word conjures images of Polish workers in Gdask in 1981, forming the first union independent of the government in the Soviet bloc, going underground during martial law and emerging to form the nucleus of the first post-Soviet Polish government.

Solidarity. The word brings me back to the first national protest march against Reaganism, organized by the AFL-CIO, which I happily attended in that same 1981. Little did I know that 40 years on, I would still be opposed to Reaganism and (almost) all it stood for. I still have the poster from that day and it has emblazoned across it the word "Solidarity."

Solidarity. The word brings to mind St. John University's theology professor Meghan Clark's wonderful book The Vision of Catholic Social Thought: The Virtue of Solidarity and the Praxis of Human Rights, which I reviewed here. Clark also penned an excellent essay on solidarity for Distinctly Catholic back in 2014. It still reads very well.

Most of all, however, when I think of the word solidarity, I think of the three conferences on erroneous autonomy that I helped Stephen Schneck organize. Schneck was then the director of the Institute for Policy Research and Catholic Studies, and we worked hand-in-glove with the AFL-CIO on all three of the conferences. The second was held at the AFL-CIO headquarters and was a most memorable day, as two western Pennsylvania natives, AFL-CIO president Richard Trumka and Cardinal Donald Wuerl, delivered the keynote addresses. On that day, I came to understand how the word solidarity informed the entire culture of organized labor.

I also came to understand that the opposite of solidarity is libertarianism, and while I often fall short of the demands of solidarity, there is not a libertarian bone in my body. Even on freedom of speech, where I am closest to a libertarian position, I recognize there are limits, that the Constitution protects language meant to persuade, not language meant to incite, while recognizing that who gets to define the difference between the two is a tricky matter.

If the pandemic has taught us anything as a culture, it has taught us the limits of libertarianism and the hypocrisy of those who invoke it in one area of life but ignore it in others. Here, in rural America where I live, it is not uncommon to encounter people who refuse to wear a mask. "It is my choice," they say, although the mask is not intended to help them but to help the rest of us. People say, casually, "Well, I am not worried about keeping protocols like self-quarantining, because my visitor is healthy," forgetting that the protocols do not guarantee any one individual's health, but the public health of us all.

Public health measures aim to limit the spread of a disease so that the system is not overwhelmed. Libertarianism has no place in a pandemic. When I pass a house flying a Gadsden "Don't tread on me!" flag, I want to stop and say, "OK, I won't tread on you if you won't infect the rest of us with a virus."

In American culture, however, the most destructive libertarian arguments manifest themselves in discussions of economic policy. Over dinner this summer, dear friends of mine who own a small business expressed the typical Republican talking point that it does not make sense to punish someone for being successful by taxing them more. I asked why they saw it as a punishment, rather than as an investment in the roads that bring the goods they sell to their store, in education to the population from which they draw their employees, in protection of the water that supplies their breweries. They are responsible for improvements within the walls of their store, but taxes take care of the improvements needed outside those walls, but no less necessary to the success of their business. My friends said they had never thought of it that way.

The fables of rugged individualism that condition so much of the culture's core beliefs, combined with the dominance of neoliberal economic ideas and globalization have brought us to where we are: incapable of mounting an effective defense against a pandemic. It is not only the acids of modernity of which Walter Lippmann warned in 1929 that have eaten away at the fabric of our culture, it is the stuff we are sold, and sold cheap, the entertainments that come into our living rooms, the propaganda of material happiness, all of it.

It has been 20 years since sociologist Robert Putnam published his book Bowling Alone: The Collapse and Revival of American Community. You cannot understand the appeal of Trump, and the sense of belonging his racism is designed to foment, unless you see how correct Putnam was and is. When I left my hometown in 1980, the two churches were mostly full every Sunday, and there was an active Grange and 4-H, Boy Scouts and Girl Scouts, a community players troupe that performed two plays a year. When I moved back in 2017, the churches are both open but are a quarter full, the Grange has become a "community center" that is rarely used, the Scouts are still active, and there has not been a community play in 30 years. If I did not meet my neighbors walking my dog each morning and evening, where would I meet them?

Politics alone will not restore the sense of community we need to rekindle in this country. Indeed, in its current form, it further polarizes us. Our churches, like our unions, must become places where community is formed and nurtured. This is especially important for us Catholics.

The word "catholic" means universal, that is, the church can bring the Gospel of Jesus Christ anywhere on the globe, into any culture and into every human heart. The Gospel must be able to find a place in a liberal heart and in a conservative heart, in a rich town and a poor one, in a European country and in an African one, on both sides of every division that separates humankind one from another. That is what it means to be Catholic, and never in the history of this nation has the culture needed to be more Catholic!

I learned and am still learning what solidarity means, what it looks like, and what policies it requires, by talking with my friends in organized labor. When word spread that Pope Francis is planning to release a new encyclical and that the topic is solidarity, my non-Catholic union friends were more excited than my Catholic friends!

On this Labor Day, I am so grateful for the contribution organized labor makes every day to off-setting the dominant libertarianism of the culture. If I could wish one thing, and one thing only, for U.S. culture, it would be a resurgence of the labor movement. Perhaps, after this horrible pandemic, that culture will be ready to hear the message organized labor and now Francis has to impart: We human beings can only thrive in a culture that builds and rewards solidarity.

[Michael Sean Winters covers the nexus of religion and politics for NCR.]

Editor's note:Don't miss out on Michael Sean Winters' latest.Sign upand we'll let you know when he publishes newDistinctly Catholiccolumns.

See original here:

Solidarity is key to organized labor and the revival of community - National Catholic Reporter

Host of energy issues hang in the balance in down-ticket races – S&P Global

The 2020 election cycle has the potential to reshape energy and environmental issues across the federal landscape and state lines. Much of the national discussion has focused on the presidential race between Donald Trump and Joe Biden, but voters will face a host of ballot choices that will influence the power, gas and oil markets for years to come.

At the federal level, control of the U.S. Congress is up for grabs. Democratic control could usher in a new era of clean energy policymaking, while a split could cement political gridlock and disrupt presidential ambitions.

At the state level, high-impact ballot measures face voter review on Nov. 3, including proposals to mandate a 50% renewable portfolio standard by 2030 in Nevada; to shake up the utility regulator in New Mexico by reducing commissioners, making them appointed positions and elongating their tenure; and to change energy tax-related issues in Alaska and Louisiana. Energy and environmental issues also play heavily into several high-profile races for governor, state legislatures and key state commissions.

READ MORE: Sign up for our weekly election newsletter here, and read our latest coverage here.

Hanging over it all will be the fundamentals of the U.S. economy and energy markets, already roiled by the coronavirus pandemic. An already volatile 2020 could temper regulatory policy pendulum swings, as policymakers and elected officials remain mindful of the damage already inflicted on the energy sector by the pandemic and associated economic downturn.

The following is an overview of key races and ballot measures:

Congressional balance of power

Overview: Republicans hold a three-seat majority in the Senate, which has given them control over nominees and chairmanships on committees vital to energy legislation. But if Democrats were to sweep at the federal level, it would have long-term implications for the energy sector should Congress pass climate and clean energy legislation.

Most polls predict: Toss-up for Senate; Democrats strongly favored to hold the House.

Energy impact: A blue Congress could eliminate the Senate's filibuster, which in turn could ensure more progressive legislation passes. Democrats running both chambers could use the Congressional Review Act to overturn some of the Trump administration's rulemakings. The left could also pack climate-focused provisions and clean energy funding into economic recovery legislation in the near- to mid-term, should Democrats maintain control of the House and retake the Senate.

While Biden has proposed to completely decarbonize the U.S. power sector by 2035, even a Democrat-led Congress would likely pass a more watered-down, though still "historically ambitious," version of that emissions-reduction plan given headwinds from congressional Republicans, states and market constraints, according to David Livingston, a senior analyst with the Eurasia Group.

"It's not unusual for a policy as ambitious as the power sector one to go through the congressional process ... and perhaps arrive at a compromise outcome," Livingston said.

But if a Democrat-led Congress deferred to the executive branch to govern through executive orders and regulations in the energy sector as has been the case in recent years those changes and policies may not be as long-lasting, according to Sasha Mackler, director of the Energy Project at the Bipartisan Policy Center. A Democratic majority may also include more moderate lawmakers from purple states, requiring climate policy to remain "pragmatic and bipartisan in nature," the director said.

Democratic Senators representing carbon-intensive states, such as Joe Manchin of West Virginia, might be more reluctant to support legislation providing incentives for clean energy over traditional fossil fuels, according to Matt Williams, emissions and clean energy analyst with S&P Global Platts Analytics.

Unlike when the White House changes hands between political parties, congressional power shifts are less likely to yield dramatic effects, according to William Yeatman, a research fellow with the Cato Institute. "Why would Congress lift a finger in this arena when the president can do it all for them, essentially?" Yeatman asked.

A possible Biden presidency with a divided Senate may resort to more executive action. But just as the Obama administration which relied on the Environmental Protection Agency's Clean Air Act authority to implement the Clean Power Plan found one of its major climate efforts stymied by a Supreme Court stay, a Biden administration could face similar obstacles without a strong Democratic majority in Congress, Williams noted.

Democrats' chances of retaking the Senate are unclear, and there are several toss-up races featuring significant energy issues including in Colorado, Iowa and Montana where a Republican incumbent faces a difficult reelection bid.

Republicans appear less likely to flip the House, but doing so would limit climate policy advancements, according to the Bipartisan Policy Center's Mackler. A split Congress would be unlikely to pass partisan energy or climate legislation, continuing the current political gridlock in the Capitol.

Gubernatorial races

Washington

Overview: Democratic incumbent Gov. Jay Inslee holds a sizable lead in the polls against Republican Loren Culp, the current police chief for the city of Republic.

Polls predict: The latest poll shows Inslee leading 61% to 32%. During a primary that featured 36 candidates, Culp earned a spot in the general election by receiving 18% of the vote compared to Inslee's 51%.

Energy impact: Dubbed "the greenest governor in the country" when he won the governorship eight years ago, Inslee in 2019 signed legislation placing Washington on the path to have a carbon-neutral electrical grid by 2030 and 100% renewable energy by 2045. Culp has said little regarding energy policy for the state, but he generally favors less government regulation and supports free-market solutions. If elected, Culp has said he intends to immediately end coronavirus restrictions and fully reopen all schools and businesses.

New Hampshire

Overview: Incumbent Chris Sununu serves as governor of one of only three states with Republican governors where the majority voted for Democrat Hilary Clinton in the 2016 presidential election.

Polls predict: Sununu won the general election in 2016 by a margin of 49% to 47% and in 2018 by 53% to 46%.

Energy impact: Sununu has opposed various renewable energy proposals from lawmakers. One of the leading primary Democratic candidates, state Sen. Dan Feltes, has pushed pro-solar and net metering legislation. The primary election is taking place Sept. 8.

Indiana

Overview: Republican Gov. Eric Holcomb is running against Woody Myers, a millionaire venture capitalist and former Indiana health commissioner. If Myers wins, he would become the state's first Black governor.

Polls predict: Myers faces a difficult election as the latest polls have Holcomb leading by 43 points.

Energy impact: Holcomb supports the fossil fuel industry, while Myers has called for moving to renewables. Indiana is seventh among U.S. states in coal production and second in coal consumption. In 2019, more than 59% of Indiana's net power generation came from coal. Renewable energy accounted for under 7% of the state's generation in 2019.

North Dakota

Overview: Republican Gov. Doug Burgum, a former technology company investor, is seeking his second term against veterinarian Shelley Lenz, a Democrat, in a state whose economy is dominated by fossil fuel production and consumption.

Polls predict: Burgum holds a decisive edge in early polls, leading Lenz 62% to 32%.

Energy impact: Lenz's energy platform includes a North Dakota Energy Co-op and improving energy infrastructure for both the fossil fuel and renewable sectors. Burgum supported the Dakota Access Pipeline and said he is open to finding ways to keep a large coal-fired plant open even after operator Great River Energy announced plans to close it. Oil and gas production remains integral to North Dakota's economy. The state trails only Texas in crude production and proved U.S. crude oil reserves, and holds 2% of domestic natural gas reserves. Due to a lack of adequate gathering and processing facilities, producers flared more than 200 MMcf/d of associated natural gas produced in June. The state generates more than 60% of its power through coal.

North Carolina

Overview: Gov. Roy Cooper, a Democrat, is up for reelection in the state, where he has helped to transform the North Carolina Utilities Commission into a more proactive player when it comes to tackling clean energy goals.

Polls predict: Cooper leads in the polls 50% to 40% in a race that also features the state's Republican Lieutenant Gov. Dan Forest, along with libertarian Steven DiFiore and Constitutional Party candidate Al Pisano on the ballot.

Energy impact: State leadership could prove important for gas pipelines. After a controversy involving Cooper over a multimillion-dollar fund for the state related to Duke Energy Corp.'s and Dominion Energy Inc.'s now-canceled Atlantic Coast Pipeline project, the North Carolina Department of Environmental Quality recently denied a water quality certificate for Mountain Valley Pipeline Southgate.

Ballot initiatives

Nevada

Overview: Voters will decide whether to give a second and final approval to amending Nevada's constitution to include a 50%-by-2030 renewable portfolio standard.

Energy impact: NV Energy Inc., whose utility subsidiaries serve about 1.2 million electric customers in Nevada, is already pursuing large-scale transmission and solar-plus-storage projects to meet the state's green energy goals, which include a renewable portfolio standard of 50% by 2030. Gov. Steve Sisolak signed the requirement into law in 2019.

But Nevadans are being asked whether to approve Question 6 and amend the state constitution to include the standard, which would prevent a future legislature from changing the requirement without the say-so of voters. Amending the Nevada constitution requires two rounds of voter approval. Question 6 passed the first round in November 2018, getting nearly 60% of voters' approval and setting the measure up for a vote again in 2020.

New Mexico

Overview: New Mexicans will decide whether to change how the state Public Regulation Commission is set.

Energy Impact: Constitutional Amendment 1 would reduce the number of commissioners from five to three and bring an end to elections determining the makeup of the regulatory body.

The utility regulator currently has five commissioners, each representing a district of the state and serving staggered four-year terms. Under the measure, starting Jan. 1, 2023, the New Mexico governor would appoint three commissioners chosen from a list of nominees put together by a committee. The appointments for six-year terms would also need the consent by the Senate. Approval of the measure would make future gubernatorial elections more important for utility oversight, as governors would gain greater control over the regulating body.

Public Regulation Commission incumbent Cynthia Hall, a Democrat, is facing off against Republican Janice Arnold-Jones for the District 1 seat. Democrat Joseph Maestas and Libertarian Chris Luchini are vying for the District 3 seat now held by Democrat Valerie Espinoza. Term limits prevent her from running again.

Alaska

Overview: Alaskans will vote on whether to increase taxes on certain oil production in the North Slope.

Energy Impact: The increase called for in Ballot Measure 1 would apply to North Slope fields that produced at least 40,000 barrels per day in the last calendar year and have a cumulative output of at least 400 million barrels of oil.

BP PLC, ConocoPhillips Alaska Inc. and Exxon Mobil Corp. are part of the OneAlaksa coalition urging voters to reject the measure, arguing it will increase taxes by at least 300% at $60/b oil prices and threaten oil development and jobs.

Vote Yes for Alaska's Fair Share, which is spearheading the initiative, said the increase would apply only to Alaska's largest and most profitable fields posing no threat to new development and would give the state more money to pay for things like education, healthcare and capital projects.

Louisiana

Overview: Voters in the Pelican State will decide whether to amend the state constitution to allow the presence or production of oil or gas to be taken into account when assessing the fair market value of an oil or gas well for ad valorem property tax purposes.

Energy Impact: Constitutional Amendment 2 was referred to voters in May, when both the state House of Representatives and Senate unanimously backed a related House bill. The measure has the support of the Louisiana Tax Committee, Louisiana Tax Assessor's Association, Louisiana Oil and Gas Association, and the Louisiana Mid-Continent Oil and Gas Association and is seen as putting the value of wells in the right place. Approval by voters would mean that when wells are more valuable, they will pay a little more tax and when less valuable, pay less tax, the Louisiana Oil and Gas Association said.

Colorado

Overview: A long-standing conflict over oil and gas in the state, fought via ballot initiatives in the past, is on hold.

Energy impact: Protect Colorado, a pro-drilling group, had planned to put before voters a measure to prohibit local governments from banning gas infrastructure in new buildings.

But Governor Jared Polis in July reached a deal with industry and environmental groups that could keep oil and gas issues off the ballot through 2022. As part of the bargain, Protect Colorado dropped the measure, and environmentalists agreed to stop pursuing stricter setback requirements for oil and gas developments.

The deal is meant to give the state more time to implement Senate Bill 181, a law passed in 2019 that changed the mission of the Colorado Oil and Gas Conservation Commission and gave local governments a bigger say in drilling.

State commissions, legislatures

Texas Railroad Commission

Overview: One of three Texas Railroad Commission seats is in play in November, with three candidates in the running. The RRC regulates oil and gas drillers.

Energy Impact: Republican Jim Wright, owner of several South Texas oilfield services firms, opposes tighter restrictions on natural gas flaring, which surged in 2019 as oil producers wanted to keep producing but lacked access to pipelines to move associated gas volumes. He beat high-profile incumbent Ryan Sitton by more than 10 points in a primary runoff but has since come under fire from a Houston Chronicle investigation alleging his company, Dewitt Recyclable Products, violated commission rules more than 200 times.

Democrat Chrysta Castaeda, a Dallas energy lawyer, has promised to clamp down on flaring, which could limit future oil production. She also favors stricter water reclamation rules. "Texans deserve someone who will enforce the law and work for all of us. Let's stop wasting energy," she said in a campaign video. Castaeda supports the RRC retaining a supply coordinating role a function that came up during the spring oil price crash under a proposed proration policy.

Libertarian Matt Sterett also has come out against flaring but favors fracking generally. He wants to reduce oil and gas industry administrative burdens by cutting regulations and paperwork. The Railroad Commission "has the ability to restrict gas flaring by simply denying permits," he said in a 2020 Ballotpedia survey.

Arizona Corporation Commission

Overview: The Arizona utility regulator has three seats out of five up for election, with the field of candidates split between three Republicans and three Democrats.

Energy Impact: The outcome could affect utility Arizona Public Service Co.'s pathway to achieving its recently declared 100% clean energy goal and determining what resources are included. Multiple candidates from both parties are pushing clean energy targets, and incumbent Republican Lea Marquez Peterson and Democrat Shea Stanfield have said they are in favor of 100% clean power policies. Arizona ranks third in the U.S. in solar power capacity but generates most of its electricity from natural gas, nuclear and coal.

Texas Legislature

Overview: After more than dozen years in the minority in the state House of Representatives, Democrats are aiming to take back the chamber, where all 150 seats are up for grabs. Republicans hold 83 House seats to Democrats' 67. A total of 16 seats out of the Senate's 31 are up for election. Presently, Democrats hold 12 Senate seats and Republicans hold 19.

Energy Impact: Clean energy advocates say that a blue state House could alter energy conversation especially after years of playing defense on tax incentives for wind energy and create openings for bipartisan support for electric vehicles, distributed resources and energy storage. A Democratic majority could also draft legislation to address oil and gas industry methane leakage and flaring, but without support from the Senate and/or governor's office, the impacts may be limited.

Michigan Legislature

Overview: The state House of Representatives could flip to Democratic control with all 110 seats up for election. Heading into the election, Republicans held 58 seats, while Democrats held 51.

Energy Impact: Democratic control of the House would potentially bolster initiatives Gov. Gretchen Whitmer has sought to pursue through the executive branch toward her goal of 100% clean energy. Michigan remains heavily coal-dependent for power generation, with more than 30% of the state's net generation in 2019 coming from coal. Still, renewable capacity grew to supply 8% of Michigan's power in 2019. A Democrat-controlled House could support additional renewable-energy-friendly policies.

Pennsylvania General Assembly

Overview: Both the state House and Senate look to be close races. All 203 seats up for election in the House where Republicans currently have control, 109 to 93. In the Senate, 25 seats out of the chamber's 50 are up for grabs. There, Republicans have control 28 to 21, with one Independent.

Energy Impact: The red House has put the brakes on some clean energy items, such as a bill on energy efficiency that advanced in the Senate, indicating that a shift to blue could enable more climate-friendly energy policy. Gov. Tom Wolf may also tighten gas industry regulations, and on the power side, efforts remain underway for Pennsylvania to join the Regional Greenhouse Gas Initiative, an emissions cap-and-trade program.

Minnesota Legislature

Overview: The Senate may flip to Democratic control in a tight race where all 67 seats are up for grabs; Republicans currently control the chamber 35 to 32. All 134 House seats are up for election, where Democrats control the majority 75 to 59.

Energy Impact: The state may be positioned to join states with 100% clean energy goals if the Senate goes blue. Governor Tim Walz strongly supported the measure in 2019, a year in which more than 30% of Minnesota's net generation came from coal. Minnesota is also among the nation's top-five ethanol producers, and about 30% of all U.S. crude oil imports flow through the state.

Jared Anderson and Brandon Evans are reporters for S&P Global Platts. S&P Global Platts and S&P Global Market Intelligence are owned by S&P Global Inc.

Follow this link:

Host of energy issues hang in the balance in down-ticket races - S&P Global

Why COVID-19 is more deadly in people with obesityeven if they’re young – Science Magazine

Many very sick COVID-19 patients, like some in this Brazilian intensive care unit, have obesity.

By Meredith WadmanSep. 8, 2020 , 6:00 PM

Science's COVID-19 reporting is supported by the Pulitzer Center and the Heising-Simons Foundation.

This spring, after days of flulike symptoms and fever, a man arrived at the emergency room at the University of Vermont Medical Center. He was youngin his late 30sand adored his wife and small children. And he had been healthy, logging endless hours running his own small business, except for one thing: He had severe obesity. Now, he had tested positive for COVID-19 and was increasingly short of breath.

He was admitted directly to the intensive care unit (ICU) and was on a ventilator within hours. Two weeks later, he died.

He was a young, healthy, hardworking guy, recalls MaryEllen Antkowiak, a pulmonary critical care physician who is medical director of the hospitals ICU. His major risk factor for getting this sick was obesity.

Since the pandemic began, dozens of studies have reported that many of the sickest COVID-19 patients have been people with obesity. In recent weeks, that link has come into sharper focus as large new population studies have cemented the association and demonstrated that even people who are merely overweight are at higher risk. For example, in the first metaanalysis of its kind, published on 26 August inObesity Reviews, an international team of researchers pooled data from scores of peer-reviewed papers capturing 399,000 patients. They found that people with obesity who contracted SARS-CoV-2 were 113% more likely than people of healthy weight to land in the hospital, 74% more likely to be admitted to an ICU, and 48% more likely to die.

A constellation of physiological and social factors drives those grim numbers. The biology of obesity includes impaired immunity, chronic inflammation, and blood thats prone to clot, all of which can worsen COVID-19. And because obesity is so stigmatized, people with obesity may avoid medical care.

We didnt understand early on what a major risk factor obesity was. Its not until more recently that weve realized the devastating impact of obesity, particularly in younger people, says Anne Dixon, a physician-scientist who studies obesity and lung disease at the University of Vermont. That may be one reason for the devastating impact of COVID-19 in the United States, where 40% of adults are obese.

People with obesity are more likely than normal-weight people to have other diseases that are independent risk factors for severe COVID-19, including heart disease, lung disease, and diabetes. They are also prone to metabolic syndrome, in which blood sugar levels, fat levels, or both are unhealthy and blood pressure may be high. A recent study from Tulane University of 287 hospitalized COVID-19 patients found that metabolic syndrome itself substantially increased the risks of ICU admission, ventilation, and death.

But on its own, BMI [body mass index] remains a strong independent risk factor for severe COVID-19, according to several studies that adjusted for age, sex, social class, diabetes, and heart conditions, says Naveed Sattar, an expert in cardiometabolic disease at the University of Glasgow. And it seems to be a linear line, straight up.

The impact extends to the 32% of people in the United States who are overweight. The largest descriptive study yet of hospitalized U.S. COVID-19 patients, posted as a preprint last month by Genentech researchers, found that 77% of nearly 17,000 patients hospitalized with COVID-19 were overweight (29%) or obese (48%). (The Centers for Disease Control and Prevention defines overweight as having a BMI of 25 to 29.9 kilograms per square meter, and obesity as a BMI of 30 or greater.)

Another study captured the rate of COVID-19 hospitalizations among more than 334,000 people in England. Published last month in theProceedings of the National Academy of Sciences, it found that although the rate peaked in people with a BMI of 35 or greater, it began to rise as soon as someone tipped into the overweight category. Many people dont realize they creep into that overweight category, says first author Mark Hamer, an exercise physiologist at University College London.

Among 334,000 people in England this spring, the chances of being hospitalized with COVID-19 increased steadily with their body mass index (BMI).

Hamer et al., PNAS, 10.1073/pnas.2011086117

The physical pathologies that render people with obesity vulnerable to severe COVID-19 begin with mechanics: Fat in the abdomen pushes up on the diaphragm, causing that large muscle, which lies below the chest cavity, to impinge on the lungs and restrict airflow. This reduced lung volume leads to collapse of airways in the lower lobes of the lungs, where more blood arrives for oxygenation than in the upper lobes. If you are already starting [with] this mismatch, you are going to get worse faster from COVID-19, Dixon says.

Other issues compound these mechanical problems. For starters, the blood of people with obesity has an increased tendency to clotan especially grave risk during an infection that, when severe, independently peppers the small vessels of the lungs with clots. In healthy people, the endothelial cells that line the blood vessels are normally saying to the surrounding blood: Dont clot, says Beverley Hunt, a physician-scientist whos an expert in blood clotting at Guys and St. Thomas hospitals in London. But we think that signaling is being changed by COVID, Hunt says, because the virus injures endothelial cells, which respond to the insult by activating the coagulation system.

Add obesity to the mix, and the clotting risk shoots up. In COVID-19 patients with obesity, Hunt says, Youve got such sticky blood, oh mythe stickiest blood I have ever seen in all my years of practice.

Immunity also weakens in people with obesity, in part because fat cells infiltrate the organs where immune cells are produced and stored, such as the spleen, bone marrow, and thymus, says Catherine Andersen, a nutritional scientist at Fairfield University. We are losing immune tissue in exchange for adipose tissue, making the immune system less effective in either protecting the body from pathogens or responding to a vaccine, she says.

The problem is not only fewer immune cells, but less effective ones, adds Melinda Beck, a co-author of theObesity Reviewsmetaanalysis who studies obesity and immunity at the University of North Carolina, Chapel Hill. Becks studies of how obese mice respond to the influenza virus demonstrated that key immune cells called T cells dont function as well in the obese state, she says. They make fewer molecules that help destroy virus-infected cells, and the corps of memory T-cells left behind after an infection, which is key to neutralizing future attacks by the same virus, is smaller than in healthy weight mice.

Becks work suggests the same thing happens in people: She found that people with obesity vaccinated against flu had twice the risk of catching it as vaccinated, healthy weight people. That means trials of vaccines for SARS-CoV-2 need to include people with obesity, she says, because coronavirus vaccines may be less effective in those people.

Beyond an impaired response to infections, people with obesity also suffer from chronic, low-grade inflammation. Fat cells secrete several inflammation-triggering chemical messengers called cytokines, and more come from immune cells called macrophages that sweep in to clean up dead and dying fat cells. Those effects may compound the runaway cytokine activity that characterizes severe COVID-19. You end up causing a lot of tissue damage, recruiting too many immune cells, destroying healthy bystander cells, says Ilhem Messaoudi, an immunologist who studies host responses to viral infection at the University of California, Irvine. Of the added risk from obesity, she adds: I would say a lot of it is immune-mediated.

The severity of COVID-19 in people with obesity helps explain the pandemics disproportionate toll in some groups. In American Indians and Alaska Natives, for example, poverty, lack of access to healthy food, lack of health insurance, and poor exercise opportunities combine to render rates of obesity remarkably high, says Spero Manson, a Pembina Chippewa who is a medical anthropologist at the University of Colorados School of Public Health. And obesity is connected to all these other [illnesses], such as diabetes and cardiovascular disease, rendering us susceptible to severe COVID-19, Manson says.

In addition, a large body of literature shows that people with obesity may delay seeking medical care due to fear of being stigmatized, increasing their likelihood of severe disease or death. Patients that experience weight stigma are less likely to seek care and less likely to seek follow up because they dont feel welcome in the health care environment, says Fatima Cody Stanford, an obesity medicine physician-scientist at Harvard Medical School and Massachusetts General Hospital.

COVID-19specific research on this question is urgently needed, she adds. We dont know how many people are dying in the community that are never making it in, Stanford says. Maybe that was [due] to their weight or to their race, the two most prevalent forms of stigma in the U.S.

For people with obesity, the extra risk adds a psychological burden, says Patty Nece, vice chair of the Obesity Action Coalition. My anxiety is just totally ramped up, she says, adding that because of stress eating shes recently regained 30 of the 100 pounds she lost before the pandemic. You have the general anxiety of this pandemic and then you layer on top of it: You in particular, you could get really sick.

Data on how to treat COVID-19 patients with obesity are scant. Published evidence supports giving such patients higher doses of anticoagulants, says Scott Kahan, an obesity medicine physician who directs the National Center for Weight and Wellness. But very little is known about whether and how to adjust other treatments such as remdesivir and dexamethasone, partly because patients with obesity are often excluded from clinical trials, he says. He urges that COVID-19 treatment trials include people with high BMIs wherever possible.

People with obesity should take extra care to avoid getting sick, Messaoudi says. If you are a person with obesity, be extra, extra cautious, she says. Wear your mask. Wash your hands. Avoid large gatherings.

In addition, exercising and, separately, losing even a little weight can improve the metabolic health of a person with obesity, and, in doing so, reduce their chances of developing severe COVID-19 if they become infected, says Stephen ORahilly, a physician-scientist who directs the MRC Metabolic Diseases Unit at the University of Cambridge. If youre 300 pounds, even losing a modest amount is likely to have a disproportionate benefit on how well you do with coronavirus infection. You dont have to become a slim Jim to benefit.

See more here:

Why COVID-19 is more deadly in people with obesityeven if they're young - Science Magazine

COVID-19 Daily Update 9-8-2020 – West Virginia Department of Health and Human Resources

TheWest Virginia Department of Health and Human Resources (DHHR) reports as of 10:00 a.m., on September 8,2020, there have been 462,547 total confirmatorylaboratory results received for COVID-19, with 11,661 totalcases and 250 deaths.

DHHR has confirmed the deaths of a63-year old female from Kanawha County, a 78-year old female from Putnam County,and an 85-year old female from Kanawha County. We mourn the tragic loss of these West Virginiansand send our deepest sympathies to their loved ones, said Bill J. Crouch, DHHRCabinet Secretary.

CASES PER COUNTY: Barbour(35), Berkeley (837), Boone (157), Braxton (9), Brooke (102), Cabell (595),Calhoun (19), Clay (29), Doddridge (13), Fayette (420), Gilmer (20), Grant(144), Greenbrier (106), Hampshire (93), Hancock (132), Hardy (76), Harrison(304), Jackson (219), Jefferson (394), Kanawha (1,737), Lewis (36), Lincoln (126),Logan (522), Marion (232), Marshall (134), Mason (123), McDowell (74), Mercer(350), Mineral (147), Mingo (282), Monongalia (1,433), Monroe (138), Morgan(41), Nicholas (58), Ohio (297), Pendleton (45), Pleasants (15), Pocahontas(45), Preston (142), Putnam (352), Raleigh (393), Randolph (228), Ritchie (6),Roane (37), Summers (21), Taylor (110), Tucker (12), Tyler (15), Upshur (50),Wayne (300), Webster (7), Wetzel (45), Wirt (8), Wood (324), Wyoming (72).

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 Fayette Countyin this report.

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

Go here to see the original:

COVID-19 Daily Update 9-8-2020 - West Virginia Department of Health and Human Resources

Escape The Pandemic: Summer Camps Offer COVID-19-Free Bubbles This Fall – NPR

Camp Robin Hood in in Freedom, N.H., was one of the few around the country to offer a summer sleepover camp. This fall, it's offering a program where students can live and attend classes remotely. Jacob Spiers/Camp Robin Hood hide caption

Camp Robin Hood in in Freedom, N.H., was one of the few around the country to offer a summer sleepover camp. This fall, it's offering a program where students can live and attend classes remotely.

As millions of students return to virtual classes at their dining room tables, some parents who are also trying to work from home have decided to ship their kids off to camp.

This might seem crazy given reports that some sleepover camps that tried to open this summer turned in to coronavirus hot spots. At one camp in Georgia, hundreds of campers ended up getting infected with COVID-19. In fact, most sleepover camps in the U.S. didn't open at all due to concerns about spreading the virus among kids crammed into bunks and sharing communal toilets.

But some others that managed to successfully keep the virus at bay this summer are now offering a refuge from the virus to those who can afford it where students can live and attend classes remotely.

"Instead of working at their dining rooms at home, they're going to work at the dining room" at Camp Robin Hood, says Richard Woodstein, director of the camp, located in Freedom, N.H.

It's offering a five-week Semester at Camp starting Sept. 13. Campers will log in to their remote classes in the morning. "And once they're done with their work," he says, "we'll do camp stuff."

But this will all be done with strict COVID-19 protocols. Robin Hood and other camps that operated successfully over the summer used similar plans to deal with the virus. And Woodstein is confident they can do it again this fall.

In the days before anyone came to the camp, they had to get tested for the virus. Then the campers were tested again once they arrived.

"Every child at the front gate was given a nasal swab," Woodstein says. "We checked everyone's temperature in the cars. We won't let the parents get out of the cars."

The kids were divided up by bunks in to groups of 10. For the first week until everyone had passed a third COVID-19 test, campers from one bunk couldn't interact with kids from other bunks unless everyone was wearing masks.

Camp officials canceled all the usual field trips and excursions that they'd usually do outside of the 180-acre camp.

"Once we closed the drawbridge, nobody was allowed to leave," Woodstein says.

They hosted 300 kids this summer and there were no cases of COVID-19.

For the fall Semester at Camp, the plan is to create a similar bubble a world walled off from the pandemic.

But Woodstein cautions it wasn't easy. "We showed a lot of respect to the disease, a lot of respect to how quickly it could spread. But we just had a lot of processes in place. We washed our hands like crazy."

This fall, it's not just Robin Hood that's offering parents an alternative.

Camp North Star in Wisconsin is taking kids as young as 8 for a five-week fall session. A YMCA camp in North Carolina is renting out its cabins to kids and their parents, calling it a "solution for remote school and work."

So, are all of these just coronavirus disasters waiting to happen? A study published by the Centers for Disease Control and Prevention says no. Looking at more than 1,000 kids and staff who attended four camps this summer in Maine, the researchers found only three people tested positive for COVID-19 and the virus didn't spread.

Dr. Laura Blaisdell, the medical director at one of the camps and a lead author of the study, says there was no single magic bullet for keeping COVID-19 at bay.

"The magic bullet is the kitchen sink," Blaisdell says.

The key was to follow the science, she says, and put in place every public health measure they could "whether that's masking, physical distancing, testing, screening, temperature taking."

If anyone in a cabin came down with symptoms that might be COVID-19, the entire cabin was quarantined while the suspected case was tested for the virus.

But the quarantined campers still went on hikes and went swimming. They just didn't interact with the other bunks. Blaisdell says quarantine wasn't as bad as you might think.

"No, we didn't chain them to their bunk and throw them reams of meat," she says with a laugh.

As soon as the test results came back negative, the campers were released back into games of gaga ball and capture the flag.

Inside their sealed perimeters, these camps have shown that with enough testing and safety protocols they can create a world away from the virus. But the bubble comes at a price.

The fall session at Camp Robin Hood costs $9,000 for five weeks, which covers all expenses including COVID-19 testing.

Original post:

Escape The Pandemic: Summer Camps Offer COVID-19-Free Bubbles This Fall - NPR

COVID-19 Daily Update 9-7-2020 – West Virginia Department of Health and Human Resources

TheWest Virginia Department of Health and Human Resources (DHHR) reportsas of 10:00 a.m., on September 7, 2020, there have been 461,558 total confirmatory laboratory results receivedfor COVID-19, with 11,575 total cases and 247 deaths.

DHHR has confirmed the death of an 86-year old female fromKanawha County. On this Labor Day, we must remember thoseWest Virginians who have lost their lives, said Bill J. Crouch, DHHR CabinetSecretary. We offer our deepest sympathies to all affected by COVID-19.

CASESPER COUNTY: Barbour (35), Berkeley (831), Boone(157), Braxton (9), Brooke (102), Cabell (589), Calhoun (18), Clay (29),Doddridge (13), Fayette (421), Gilmer (20), Grant (144), Greenbrier (106),Hampshire (93), Hancock (128), Hardy (76), Harrison (301), Jackson (217),Jefferson (389), Kanawha (1,731), Lewis (36), Lincoln (126), Logan (519),Marion (230), Marshall (134), Mason (120), McDowell (74), Mercer (350), Mineral(147), Mingo (280), Monongalia (1,401), Monroe (138), Morgan (41), Nicholas(57), Ohio (297), Pendleton (45), Pleasants (15), Pocahontas (45), Preston (141),Putnam (350), Raleigh (391), Randolph (228), Ritchie (6), Roane (37), Summers(21), Taylor (110), Tucker (12), Tyler (15), Upshur (46), Wayne (298), Webster(7), Wetzel (45), Wirt (8), Wood (324), Wyoming (72).

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 LoganCounty in this report.

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

Read more:

COVID-19 Daily Update 9-7-2020 - West Virginia Department of Health and Human Resources

Governor Cuomo Launches "The COVID-19 Report Card," An Online Dashboard Tracking Real-Time COVID-19 Infections and Testing Operations of…

Governor Cuomo Launches "The COVID-19 Report Card," An Online Dashboard Tracking Real-Time COVID-19 Infections and Testing Operations of Every New York School and School District | Governor Andrew M. Cuomo Skip to main content September 8, 2020

Albany, NY

Signs Executive Order to Ensure Schools, Local Health Departments, Labs, and All Testing Sites Properly Collect and Report COVID-19 Data on Daily Basis

COVID-19 Report Card Data Includes: Positive Cases by Date of Students and Staff; Number of Students and Staff On-Site; Percentage of On-Site Positive Cases; Number of Tests Administered by School, Test Type, Lab Used and Lag Time; Date of Last Submission and Update

Governor Andrew M. Cuomo today announced the launch of "The COVID-19 Report Card", an online dashboard which tracks real-time COVID-19 infections and testing operations of every New York school and school district. The Governor acted by Executive Order directing schools, local health departments, labs and all testing sites properly collect and report COVID-19 testing data for students and staff at each school in New York State, ensuring this information can be accurately presented on the online COVID-19 Report Card.

Audio Photos

As schools reopen and districts, local health departments, and labs begin reporting this data to the NYS Dept. of Health, the COVID-19 Report Card will be live at:https://schoolcovidreportcard.health.ny.gov/

"Facts empower people to make informed decisions for the health and safety of themselves and their families,"Governor Cuomo said."The COVID-19 Report Card will give parents, faculty and students the most up-to-date information on the status of their school and their school district's testing and results. I urge our school communities to stay vigilant and be smart."

The COVID-19 Report Card will give parents, faculty and students the most up-to-date information on the status of their school and their school district's testing and results.

The COVID-19 Report Cardwill provide parents, teachers, students and all New Yorkers with comprehensive data updated on a daily basis, including:

The COVID-19 Report Card online dashboard features user-friendly design to make it easy for parents, teachers, students and all New Yorkers to access the data in one central location. Visitors to the website can simply type in their home address to identify their school district, select their specific school, and find all reported positives, a breakdown of testing and results for students and teachers and the current enrollment. The dashboard will feature 7-day trend charts so visitors can track results over time.

The State of New York does not imply approval of the listed destinations, warrant the accuracy of any information set out in those destinations, or endorse any opinions expressed therein. External web sites operate at the direction of their respective owners who should be contacted directly with questions regarding the content of these sites.

Read the original post:

Governor Cuomo Launches "The COVID-19 Report Card," An Online Dashboard Tracking Real-Time COVID-19 Infections and Testing Operations of...

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

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

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

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

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

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

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

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

Read this article:

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

What if There Isnt a Covid-19 Vaccine for Years? – 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

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

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.

Go here to see the original:

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

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

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.

Sign Up

Sorry. That's an invalid e-mail.

Thanks! We'll send you a confirmation e-mail shortly.

Read the original here:

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

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

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

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

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

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

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

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

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

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

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

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