Daily Archives: June 22, 2020

Soaring infections in Yakima County led Gov. Jay Inslee to announce Saturday that he would order that areas residents to wear masks in public places.

Several operating room staff members at Seattles Virginia Mason Medical Center in Seattle have tested positive for COVID-19.

Statewide, another 455 coronavirus cases were confirmed on Sunday, bringing official state totals to 28,680 diagnoses out of 474,938 tests administered, meaning a 6% positive test rate including 1,270 deaths, according to the state Department of Health.

Throughout Monday, on this page, well post updates from Seattle Times journalists and others on the pandemic and its effects on the Seattle area, the Pacific Northwest and the world. Updates from Sunday can be found here, and all our coronavirus coverage can be found here.

A Seattle entrepreneur who marketed and sold an unauthorized coronavirus vaccine has agreed to settle a lawsuit by the Washington state Attorney Generals Office by repaying his customers and permanently refraining from similar activity.

Johnny Stine on Monday signed a legally binding consent decree to repay up to 30 people hedallegedly soldhis COVID-19 spike protein vaccine to for $400 each. He also agreed to pay the Attorney Generals Office $8,500 in legal fees; $30,000 in potential fines will be suspended as long as he complies with the agreement.

Stine had faced a maximum fine of $2,000 for each of the 30 counts of allegedly selling the purported vaccine and for allegedly touting his scientific credentials and the benefits of his concoction to those questioning its legality on social media.

No COVID-19 vaccine has attained Food and Drug Administration approval, and developing one is expected to take at least until next year.

Read the full story here.

Geoff Baker

Visitors are able to enter the White House complex without having their temperatures checked for the first time since mid-March, although several other coronavirus precautions remain in place.

Those who come near the president will still undergo temperature checks and testing for the virus.

Over the past three months, those seeking to access the White House complex first had to get their temperatures checked and answer a question about whether they had experienced any symptoms associated with COVID-19. The White House said Monday it was scaling back complex-wide temperature checks as the District of Columbia enters phase two in its reopening.

Read the story here.

The Associated Press

Indias coronavirus caseload has risen to 425,282 as infections soar in rural areas to which migrant workers fleeing major cities have returned in recent weeks.

Indias health ministry on Monday reported 14,821 new cases and about 300 new deaths, bring the toll of fatalities up to more than 13,000. The coastal state of Goa reported its first COVID-19 death.

India is the fourth most-affected country globally after the United States, Brazil and Russia.

China reported 18 new cases of the coronavirus, including nine in Beijing and two in neighboring Hebei province.

South Korea has reported 17 new cases of COVID-19, the first time its daily jump came down to the teens in nearly a month. Its 40 to 50 cases per day increases over the past two weeks have occurred as people increased their public activities amid eased attitudes on social distancing. An increase in imported cases has prompted authorities to halt providing new visas for travelers from Pakistan and Bangladesh.

Read the story here.

The Associated Press

A camera trap photo of an injured tigress and a forensic examination of its carcass revealed why the creature died: A poachers wire snare punctured its windpipe and sapped its strength as the wound festered for days.

Snares like this one set in southern Indias dense forest have become increasingly common amid the coronavirus pandemic, as people left jobless turn to wildlife to make money and feed their families.

Authorities in India are concerned this spike in poaching not only could kill more endangered tigers and leopards but also species these carnivores depend upon to survive.

It is risky to poach, but if pushed to the brink, some could think that these are risks worth taking, said Mayukh Chatterjee, a wildlife biologist with the non-profit Wildlife Trust of India.

Since the country announced its lockdown, at least four tigers and six leopards have been killed by poachers, Wildlife Protection Society of India said. But there also were numerous other poaching casualties gazelles in grasslands, foot-long giant squirrels in forests, wild boars and birds such as peacocks and purple moorhens.

Read the story here.

The Associated Press

The restrictions on travel and business imposed to stem the coronaviruss spread wiped out nearly all travel revenue for Greece in April, according to Bank of Greece figures.

Provisional figures show travel receipts stood at 7 million euros in April, compared with 544 million euros in the same month last year, or a drop of 98.7%, Greeces central bank said Monday.

The fall in travel receipts resulted from a 96.2% decline in inbound traveler flows and a 62.2% decrease in average expenditure per trip, the Bank of Greece said in a statement.

Greeces economy depends heavily on tourism, which directly and indirectly accounts for around 20% of annual gross domestic product. After an early lockdown imposed in early March kept coronavirus deaths and serious illnesses at low levels, the country is reopening to visitors from abroad, with the government hoping to salvage what it can from the lucrative summer tourist season.

Read the story here.

The Associated Press

It began with a dry cough, weakness and back pain. For Reagan Taban Augustino, part of South Sudans small corps of health workers trained in treating COVID-19 patients, there was little doubt what he had.

Days later, hardly able to breathe, the 33-year-old doctor discovered just how poorly equipped his country is for the coronavirus pandemic: None of the public facilities he tried in the capital, Juba, had oxygen supplies available until he reached South Sudans only permanent infectious-disease unit, which has fewer than 100 beds for a country of 12 million people.

It took more than an hour to admit him. I was almost dying at the gate, he told The Associated Press from the unit last week.

The pandemic is now accelerating in Africa, the World Health Organization says.

South Sudan, a nation with more military generals than doctors, never had a fighting chance. Five years of civil war and corruption stripped away much of its health system, nearly half of the population was hungry before the pandemic, and a locust outbreak arrived just weeks before the virus.

Read the story here.

The Associated Press

Whats all this talk about a second wave of U.S. coronavirus cases?

In The Wall Street Journal last week, Vice President Mike Pence wrote in a piece headlined There Isnt a Coronavirus Second Wave' that the nation is winning the fight against the virus.

Many public health experts, however, suggest its no time to celebrate. About 120,000 Americans have died from the new virus, and daily counts of new cases in the U.S. are the highest theyve been in more than a month, driven by alarming recent increases in the South and West.

But there is at least one point of agreement: Second wave is probably the wrong term to describe whats happening.

When you have 20,000-plus infections per day, how can you talk about a second wave? said Dr. Anthony Fauci of the National Institutes of Health. Were in the first wave. Lets get out of the first wave before you have a second wave.

Read the story here.

The Associated Press

Infectious disease experts expressed alarm Sunday over the pace of new coronavirus infections in several states in the South and Southwest, with one likening the spread in parts of the country to a forest fire.

At the same time, President Donald Trumps surrogates insisted he was joking on Saturday when he told rally-goers he had ordered a testing slowdown because the results painted an overly dire picture of the pandemic.

With the United States now reporting a quarter of the worlds coronavirus cases, and daily new-infection counts exceeding 30,000 nationwide on at least two recent days, eight states California among them last week hit single-day new-case highs, according to figures compiled by Johns Hopkins University.

Read the story here.

Los Angeles Times

Nearly 26% of parents with children 6 months to 18 years old say they are hesitant to have their children get a flu shot, according to research published in the journal Pediatrics.

It found that the parents reluctance stems not from concerns about safety but from doubts about the effectiveness of the influenza vaccine. By contrast, just 6% of parents question the effectiveness of routine childhood vaccines, such as those for measles, mumps and whooping cough.

Public health experts are particularly concerned that people of all ages get flu shots this year, given that the flu season and an expected second wave of cases of the new coronavirus are likely to coincide this fall and winter, severely stressing hospitals and the health-care system generally.

Read the full story here.

The Washington Post

NEW YORK Tour promoter Live Nation has announced its first-ever drive-in concerts series in the U.S. for July, months into the live music industry's lockdown due to the coronavirus pandemic.

The entertainment company on Monday announced Live from the Drive-In a set of nine shows to take place July 10-12 in Nashville, Tennessee; Maryland Heights, Missouri; and Noblesville, Indiana. Performers include Nelly, Brad Paisley, Darius Rucker and Jon Pardi.

Concertgoers will be able to drive into the parking lots of the amphitheaters a maximum of four people per car and will have two empty parking lot spaces in between each vehicle so fans can watch and party from their designated individual tailgating zones.

Read the full story here.

The Associated Press

Hot, sunny weather is on the way, but with restrictions in place and an anxiety-provoking start to 2020, the usual summery sense of ease may be hard to find.

It might seem easier to stay hunkered down. But this is, perhaps, when we need summer most of all.

Amid the interruption in our physical rhythms and daily lives, a psychiatrist has practical recommendations for taking care of yourself.

Christine Clarridge

Katherine Long

Kris Higginson

Seattle Times staff & news services

Read the original post:

Coronavirus daily news updates, June 22: What to know today about COVID-19 in the Seattle area, Washington state and the world - Seattle Times

Jha and other public health experts say that Americas piecemeal, politicized approach to fighting coronavirus has left the United States ever-further behind the Western European nations that were similarly threatened by the virus but moved more judiciously to fend it off. They also say that Western Europe is a better comparison point for the United States than nations like South Korea and Singapore, which had been scarred by previous viral outbreaks and were more prepared to handle the arrival of Covid-19. After the damaging initial spike in cases, European Union members' total daily case count is now about one-eighth of the U.S. daily cases despite having roughly the same population.

Both we and Western Europe were really slow to act, said Jeremy Konyndyk of the Center for Global Development, who helped oversee international aid efforts during the Obama administration. But the worst performers in Europe with the bad luck to get hit first, like Italy and Spain they are now down 85, 95 percent in terms of case counts from the peak.

In the US, weve struggled to get it down one-third and in the last few days, it looks like it could rebound again, Konyndyk added.

Public health experts cited multiple factors for why the fortunes of the United States have differed from Western Europe starting with the intense politicization that worked against a disciplined response, and the federal governments decision to let individual states take the lead in reopening. The decisions of some states to end their lockdowns as early as possible at levels of infection considerably higher than those that triggered reopening in Western Europe appear to have consigned the United States to a far longer battle with the virus.

President Donald Trump and some Republican governors have bristled at public health experts advice, questioning predictions on viral spread and pushing back on recommended lockdowns. GOP-led states like Georgia and Texas reopened their economies despite requests from public health experts to wait for more testing and fewer cases.

Meanwhile, Trumps allies and pundits on Fox News pushed malaria drugs as possible Covid-19 cures, despite scant evidence, leading to largely fruitless efforts that consumed the time of senior federal officials including scientists whose time would have been better spent pursuing other therapies.

There are plenty of people, on cable TV and elsewhere, who exploited that the virus was primarily in New York and other places to say that it's a blue state problem, said Harvards Jha. Theyd ask, Why are we shutting down Montana when the problem is Manhattan?

Democrats, meanwhile, didnt condemn hundreds of thousands of people for violating restrictions on mass gatherings to protest police brutality this month. Instead, governors like New Jerseys Phil Murphy and Michigans Gretchen Whitmer broke the lockdown orders that they had extended just days before to join the protests themselves moves that confused many Americans about the need for social distancing and fueled charges of hypocrisy from conservatives.

Even basic protections have been politicized in the United States. Trump has eschewed a mask in public and has sometimes mocked others for wearing face coverings despite requirements that people wear masks in certain states and ample science that they work to prevent the virus spread.

The president also swiped at mask-wearers in a Wall Street Journal interview last Wednesday, suggesting that some Americans are wearing coverings to signal their disapproval with him. He has repeatedly voiced his hesitation about the widespread coronavirus testing urged by public health experts, including controversial remarks at his rally on Saturday.

"When you do testing to that extent, you're going to find more people," Trump said during his rally in Tulsa, Okla. "You're going to find more cases. So I said to my people, slow the testing down please." White House officials claimed Trump was joking.

But in Italy, theres been much less disagreement over scientists recommendations including lockdowns that were more restrictive than those applied in the United States particularly after the virus swiftly tore through the nation in early March, peaking at 6,557 new cases announced on March 21. (Adjusted for population, that would be equivalent to about 35,400 new cases in the United States.) While some protested, residents largely went along with restrictions that effectively banned jogging, instituted one-at-a-time entry policies for grocery stores and saw the Pope livestream his Easter Mass from an empty St. Peters Basilica.

That still wasnt enough to spare Italy from horrific consequences in the early spring: Doctors had to make decisions on the fly about who would get life-saving care when there werent enough beds to go around. Dead bodies had to be stored in sealed-off rooms until funeral services were available in the worst-hit regions.

Continued here:

The U.S. has hamstrung itself: How America became the new Italy on coronavirus - POLITICO

For the fourth time in five days, Texas reported a record number of new coronavirus cases Saturday as the virus continues to surge in one of the first states that allowed businesses to reopen after a weeks-long shutdown meant to slow the pandemic.

State health officials credit some of the 4,430 new cases to a data entry backlog in Harris County, which accounted for about 1,200 of the recorded illnesses. But Texas Department of State Health Services spokesperson Chris Van Deusen said part of the increase is also attributable to Texans gathering at bars, beaches, rivers and other social gatherings like graduation parties. He also said that people testing positive in prisons and at meatpacking plants continues to contribute to the growing number of cases.

The number of Texans hospitalized with the virus 3,247 people also set a record for the ninth consecutive day Saturday. More than 2,100 Texans have died from COVID-19, the disease caused by the new coronavirus. But the true death toll is certainly higher than the state's official count.

Gov. Greg Abbott said one of the key metrics he would watch as he allowed businesses to reopen was the infection rate, or the ratio of positive cases to tests conducted. Public health experts want the daily infection rate to remain below 6%. But Texas' seven-day average infection rate has been above 6% for more than two weeks.

Still, Abbott earlier this week said there was abundant space in hospitals for people getting sick with the virus. Van Deusen said that as of Saturday, there are 13,701 available beds available, compared with 13,571 a week ago.

"Were staying in close contact with hospitals on their situations, their plans for adding beds and staff, and making plans in case there is a need to use other facilities for people who need care for COVID-19 but dont need to be in a hospital" he said.

A spokesperson for Abbott's office did not immediately respond to a request for comment Saturday

Van Deusen said the state has also dramatically increased testing with the addition of mobile testing sites, adding that there are more than 3,000 contract tracers in the state who are working to identify hotspots and where community spread is most common. Thats short of Abbotts goal of having 4,000 tracers by June 1, but Van Deusen said state and local jurisdictions are still adding to those totals.

Were still looking to ramp up because we think there is going to be more work to do, he said.

Van Deusen also said that while the DSHS gives the governors office guidance on the coronavirus response, the decision to pause or even scale back business reopenings is up to the governor.

The state has taken some proactive measures to limit contagion since reopening began last month. The Texas Alcoholic Beverage Commission said that five bars have been temporarily closed for violating reopening guidelines, which allow restaurants to operate at 75% capacity and bars at 50%.

We warned businesses TABC will have no tolerance for breaking the rules, and now, some bars are paying the price, executive director Bentley Nettles said in a statement. "I hope other establishments will learn from these suspensions.

The first infraction forces a 30-day closure, and a second violation would mean a 60-day shutdown. Meanwhile, some bars and restaurants are closing voluntarily after employees have tested positive for the virus. Owners are balancing feedback from staff members, customers and officials as they weigh such decisions.

Abbott and health officials have attributed part of the recent surge to people in their 20s, whom leaders say may not be taking social distancing and other guidelines seriously. On Saturday, Dallas County officials said that almost half of all new infections reported after June 1 have been from people aged 18 to 39.

As the pandemic began to sweep Texas in March, Abbott left it up to local governments to respond to the virus however they saw fit and said he was confident that cities would make the best decisions for their communities.

Then, he changed his mind and blasted local officials in Dallas and Houston for what he and other leaders called overzealous enforcement of COVID-19 regulations.

At an April press conference where he talked about plans for reopening the state, Abbott took away local officials' ability to issue fines for violating coronavirus-related orders. Since then, local officials have asked for the ability to enforce orders that mandate people wear face masks in public.

After Abbott didnt budge, local officials across the state began mandating that businesses require customers to wear face masks, which the governor said was allowable. Bexar, Travis, Hidalgo, Cameron, El Paso, Harris and Dallas are among counties that have issued orders mandating businesses require face coverings or risk fines.

But local officials have said Abbott's sending mixed message by encouraging face masks, but not requiring them with an order. Yet some fellow Republicans have criticized Abbott for allowing businesses to require face masks.

Original post:

Texas coronavirus infections set daily record with 4,430 new cases - The Texas Tribune

When the coronavirus threat was newer and seemed more immediate, Texas postponed its May elections to pick winners in several party primary runoffs, fearing the health risks of exposing voters and poll workers.

With those statewide elections about to take place, the health risks voters face are now arguably greater than when the runoffs were initially called off.

The virus appears to be in much wider circulation than the original May 26 runoff date, with the state coming off a full week of record highs for COVID-19 hospitalizations and several consecutive days of record highs for daily reported infections.

But voters won't be required to wear masks at polling places. Gov. Greg Abbott, who earlier expressed concerns about exposing Texans "to the risk of death" at crowded polling sites, has forbidden local governments from requiring people to wear them in public.

And Texas Republicans, led by state Attorney General Ken Paxton, have successfully fought off legal efforts by Democrats and some voters to let more people vote by mail if they are fearful of being exposed to the virus at polling places.

With early voting starting June 29 and election day July 14, voters are largely left on their own to balance exercising their right to vote against the health risks that come with going to the polls in a pandemic. Some fear endangering themselves, while others fear bringing the virus back into homes they share with immunocompromised loved ones. The runoffs are relatively small elections with low turnout expected the marquee race is the Democratic showdown to see who will challenge U.S. Sen. John Cornyn in November but they'll prove an instructive test run for what Texas might face come November's high octane general election.

I feel like by voting I'm risking my life. By not voting, I dont know that Im risking the state of the country in a primary, said Monica Daucourt, a Dallas teacher. How important is the primary is what I'm weighing.

With a classroom full of high schoolers, Daucourt counts on falling ill every year. Typically, it's an annual bout of bronchitis, though pneumonia was the malady last November.

Knowing she's prone to respiratory illness, Daucourt has been practicing social distancing and limiting her outings since the Irma Lerma Rangel Young Womens Leadership School where she teaches went remote. Up until last week, she was planning to momentarily lower her shield and venture out to cast her ballot. But fear crept in as she's seen record high numbers for daily new coronavirus cases and hospitalizations rolling in. Now, shes trying to figure out if her history of respiratory illnesses might count as a disability under Texas law and make her eligible to vote by mail.

I dont know what kind of story I could build around myself to qualify, said Daucourt, who is in her 50s.

Across the state, election administrators have been trying to rework the mechanics of in-person voting to see how safe they can make it. Plastic barriers will go up at check-in stations and poll workers will be wearing an assortment of protective equipment like masks, shields and finger covers. A bounty of hand sanitizer will be at the ready. In some counties, voters will receive styluses or craft sticks to mark up their ballots to avoid contact with voting equipment.

The Texas Secretary of State has offered voters a list of suggestions for keeping safe, like screening themselves for symptoms and bringing their own hand sanitizer to the polls.

Wearing masks is also something voters might want to consider, the state's chief election officer suggests.

Selena Garza, a 35-year-old Houston voter with a pre-existing health condition, figures her safest route is to have a plan.

Looking to avoid a crowd, Garza is scouting out a polling place that typically sees low foot traffic. Like other voters, shes prepared to make multiple trips to the polls if shes met with a long line of voters who arent wearing masks but she knows thats not an option available to all.

I trust that the voting locations will take the best precautions, Garza said. My concern is you're in a shared space at that point and not everybody is on the same page when it comes to the safety protocols so what do you do at that point?

Texas has reached its runoff elections after fighting in court to keep its strict voting by mail rules in place during the pandemic for voters under the age 65.

Texas is among a minority of states that require voters to present an excuse to obtain a mail-in ballot. In some of those states, Democratic and Republican officials have either moved to expand mail-in voting due to the pandemic or allowed voters to use the coronavirus as a reason to vote by mail during the upcoming elections. But Texas Republican leaders have been unwilling to budge.

The option remains for people with disabilities or conditions that make a trip to the polls risky to their health. But the legal definition of a disability under state election law remains murky after several rounds of litigation. In fielding calls about voting by mail eligibility, local election officials have been quoting the Texas Supreme Courts recent ruling on the issue: A lack of immunity to the virus alone is not enough to claim eligibility for a mail-in ballot based on a disability, but it is a factor that can be considered as part of a voters medical situation.

And they have assured voters looking to apply for a mail in ballot in good faith that counties cant question or investigate their reasoning for requesting a ballot based on a disability or medical condition. When voters cite a disability to request a mail-in ballot, they simply check a box on the application form. They arent required to say what the disability is. If their application is properly filled out, local officials are supposed to send them a ballot.

But the litigation over an expansion and lack of clarity from the state has confused some high-risk voters, including some who may actually be eligible to vote by mail but are instead considering risking exposure to the virus.

The message has been muddled, said Sylvia Scott, a 63-year-old at-home caregiver in Dallas.

A diabetic with heart issues, she has been self isolating since giving up the rotation of older residents she cared for. Despite her medical conditions, Scott isnt sure if shes eligible to vote by mail or even how to apply, and asked for guidance while speaking to a reporter.

But with her familys legacy, theres no room to let an election go by without participating. Scott, who is black, still has records of the poll taxes her grandmother was forced to pay to vote. Though contracting the virus could come with deadly consequences for her, she invokes the price paid often with their own lives by those who worked to ensure people who look like her could vote.

Im probably going to end up standing in a line exposing myself to exercise my right to vote, which I really resent, she said.

Texas narrow qualifications are also forcing households with immunocompromised family members who are otherwise avoiding interacting with others to risk carrying the virus back from potentially crowded polling places.

We haven't had any outings. We do all of our groceries curbside. Very rarely have we gone into store and when we do protect ourselves with masks and wear gloves, said Joyce LeBombard, the past president of the League of Women Voters Austin area chapter whose husband is immunocompromised.

Existing law doesnt account for families like hers in a pandemic, LeBombard said. She and her husband are both under 65. His medical condition will allow him to cite a disability to request a mail-in ballot. LeBombard, meanwhile, isnt eligible.

Shes unwilling to sit an election out so shes looking into eligibility requirements for curbside voting in hopes of limiting her contact with others at the polling place, though shes not sure she qualifies for that either. Her ability to cast a ballot could come down to driving by the polling place closest to her home until she feels comfortable with the crowd size.

While I legally know I dont qualify, its my right to go vote. It's not a privilege. Its my right. Its my duty, LeBombard said. I feel its really unfair the state is trying to force me to make that kind of decision of giving up voting so I dont put my family at risk versus going and putting my family at risk.

See more here:

Coronavirus postponed a Texas election. Now there's even greater risk for some voters. - The Texas Tribune

A bartender wearing a face mask and gloves checks a patron's ID at Under the Volcano in Houston last month. Texas is one of the states seeing a big uptick in coronavirus cases and hospitalizations. Mark Felix/AFP via Getty Images hide caption

A bartender wearing a face mask and gloves checks a patron's ID at Under the Volcano in Houston last month. Texas is one of the states seeing a big uptick in coronavirus cases and hospitalizations.

About 120,000 Americans have now died from the coronavirus.

While the national number of daily deaths has declined in recent weeks, new confirmed cases are on the rise in almost half the country, including spikes in Florida, Texas and Arizona, where the president is headed Tuesday.

"We saved millions of lives, and now it's time to open up," President Trump said definitively Saturday night during his campaign rally in Tulsa, Okla.

Trump's referring to an earlier estimate that found there could be up to 2.2 million deaths if the country did nothing to contain the outbreak. But he spent months downplaying the virus when health experts were imploring more action sooner. And those experts are now warning it's not time to act as if the pandemic is over.

"[T]hat's why I think you're seeing right now increases in a number of states, because everybody's back to a pre-pandemic mindset," Michael Osterholm, director for the Center for Infectious Disease Research and Policy at the University of Minnesota and author of Deadliest Enemy: Our War Against Killer Germs, said on NBC's Meet the Press on Sunday. He warned that the coronavirus is like a "forest fire" that is showing no signs of slowing down.

Early on, the pandemic was largely affecting "blue," or Democratic-leaning areas, especially New York, but now most new cases are in the South and redder parts of the country. The Trump administration and some Republican governors have been blaming increased testing for the rise in cases, but in many places cases are increasing more than testing and that certainly doesn't explain away rising hospitalizations in places like Texas.

The campaign of presumptive Democratic nominee Joe Biden is making competence a core part of its argument against Trump, and it hit him again for it because of other remarks he made Saturday night.

"When you do testing to that extent, you are gonna find more people, you're gonna find more cases," Trump said. "So I said to my people, 'Slow the testing down, please.' They test and they test. We have tests that people don't know what's going on."

The White House says he was being "tongue in cheek," but Trump has repeatedly said testing makes the United States look bad by, in his view, increasing the number of reported cases. A Democratic group has already cut an ad centering on his remarks.

It will be key to watch political reaction on the right if cases and hospitalizations continue to rise in these parts of the country, as things like wearing masks something the president initially encouraged Americans to do have become politicized.

So far, though, Trump's power of persuasion with his base continues to outweigh the coronavirus's shift toward Red America.

1. Possible progressive surge in elections: Five states hold primaries Tuesday Kentucky, New York, North Carolina, Virginia and Mississippi.

State Rep. Charles Booker, pictured, faces Amy McGrath in Kentucky's Democratic primary for the U.S. Senate. Bryan Woolston/AP hide caption

State Rep. Charles Booker, pictured, faces Amy McGrath in Kentucky's Democratic primary for the U.S. Senate.

In Kentucky, the race between the two Democrats vying for the right to take on Republican Senate Majority Leader Mitch McConnell is coming down to the wire. State Rep. Charles Booker has all the momentum and progressive backing over Amy McGrath, a retired Marine Corps fighter pilot who has all the money and the party endorsement but also lost a congressional race in the 2018 Democratic wave.

Either faces an uphill battle in a general election against McConnell in Kentucky, but a new video from Booker encapsulates a lot of the messages Democrats are trying to push nationally about working class economics, protests and Black Lives Matter.

In New York, pay attention to progressives going after establishment Democrats, especially in the race between longtime Rep. Eliot Engel and Jamaal Bowman, a former Bronx principal who has won the endorsements of Sen. Bernie Sanders and Rep. Alexandria Ocasio-Cortez. Missteps from Engel, who last faced a competitive primary 20 years ago, opened the door for Bowman, who has raised $2 million and is surging.

2. Battleground Arizona, Wisconsin: Speaking of elections, Trump heads to Yuma, Ariz., on Tuesday to survey part of the border fence with Mexico before heading to Phoenix. Vice President Pence, meanwhile, will be in Wisconsin. It's no coincidence that they're heading to those places amid the president's slipping poll numbers. Wisconsin and Arizona could very well be tipping-point states this November.

3. Hearing on DOJ independence Wednesday: Like something out of an episode of Showtime's Billions, Attorney General William Barr announced the resignation of Geoffrey Berman, the U.S. attorney for the Southern District of New York in Manhattan last week. Problem: Berman, who has been investigating people close to Trump, said he didn't resign. Barr later said in a statement that Berman had "chosen public spectacle over public service" and asked Trump to intervene and fire him. Trump did, but added, "[T]hat's really up to him [Barr]. I'm not involved."

And now Congress is involved to investigate it all.

House Judiciary Committee Chairman Jerry Nadler, D-N.Y., is promising to try and secure Berman's testimony. "The whole thing smacks of corruption and incompetence, which is what we have come to expect from this President and his Attorney General," Nadler said in a statement. Nadler was already slated to hold a meeting Wednesday with two whistleblowers on political interference at the Department of Justice.

4. Votes on police reform on Capitol Hill expected: The Senate will debate, and possibly vote on, police reform. There's a key procedural vote scheduled for Wednesday. On Thursday, the House is expected to pass the Democratic police reform bill mostly along party lines. You wonder how many people are tuning in to politics for the first time and watching the meat grinder of Congress work and what their impressions are do they turn away, thinking politics is futile and not a great way to effect change, or does it make them more likely to vote?

5. Trump's immigration executive order: Following his administration's loss over the DACA program, Deferred Action for Childhood Arrivals, at the Supreme Court last week, President Trump is expected to sign an executive order suspending temporary work visas through the end of the year, NPR's Franco Ordoez reports. The suspensions are expected to include visas that affect skilled workers like in the tech industry (H-1B), executives at large corporations (L-1), seasonal workers like hotel and construction workers (H-2B) and research scholars and professors (J-1).

"I said, 'General, there's no way I can make it down that ramp without falling on my ass, general.' "

Trump during his Tulsa rally on Saturday, delivering a defense of his walking down a ramp at West Point. The president noted that he had leather-soled shoes on and didn't want to fall like former President Gerald Ford coming out of the airplane.

Trump went on a long tangent to discuss and, at times, reenact, his gingerly walking down the ramp and questions raised about his using a second hand to drink water. He said he didn't want to get any on his tie. Philip Bump at The Washington Post found Trump spent one out of every eight minutes of his Tulsa speech talking about West Point, or 14 minutes and 53 seconds of a speech that lasted one hour and 43 minutes.

Originally posted here:

5 Things To Watch This Week: Coronavirus, Politics And Police - NPR

1. How COVID-19 is affecting the globe

2. Study shows women in India more likely to die of COVID-19

Globally, men are more at risk of dying from COVID-19, according to data from Italy, the US and China.

But in India, although more men are infected with the virus, the risk is of death is greater among women, according to a new study in the Journal of Global Health Science.

As of 20 May, the case-fatality ratio (the number of people who die compared to those infected) for men was estimated at 2.9% and 3.3% for women.

In particular, the risk of mortality for women was higher among three age groups: 519 years, 3039 years, and 4049 years.

More women in certain age groups are dying of COVID-19 than men.

Image: Journal of Global Health Science

Poor nutrition could play a role in the gender difference, as the authors note: "A significant proportion of women in the age group 1549 years are undernourished and this also leaves them vulnerable to an elevated risk of COVID-19 infection and severe outcomes."

They said the gendered impacts of COVID-19 outbreak in India "needed to be effectively analysed for potential public health and policy inferences".

The study was based on estimates because it used crowdsourced data, which the authors said had considerable gaps in reporting of age-sex specific information.

Confirmed cases have passed 425,000 in India, with deaths standing at more than 13,000, according to Johns Hopkins University.

3. Seafarers: Organizations work together to solve 'humanitarian' crisis

A series of meetings are starting in Geneva today (22 June) to urgently address the plight of seafarers, the world's forgotten key workers who have been stuck at sea for months.

The International Maritime Organization (IMO), the International Labour Organization (ILO), heads of business, government ministers and workers representatives will try to chart a way through the crisis before it impacts on the global supply system.

Since the coronavirus crisis began, as many as 1 in 6 of the 1 million crew on 60,000 cargo ships at sea have been marooned. Crew changes were suspended in March as a short-term solution to avoid disruption to the supply system.

The men and women still working on board are unable to disembark, with border closures, grounded aircraft and travel restrictions all preventing them from returning to their home country and families.

Taking care of the people who move our goods and enable trade leads to job creation. This is central to securing lives and livelihoods, says Margi Van Gogh, the Forums Head of Supply Chain and Transport Industries, who is coordinating the Industry Action Group with a cohort of CEOs.

Cohesive global leadership from public, private and civil society leaders is necessary to solve this deepening crisis. Cohesive leadership is also vital for the Great Reset, enabling us to build back better a sustainable global supply system is at the heart of this.

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What you need to know about the coronavirus pandemic on 22 June - World Economic Forum

As stay-at-home orders ease and cities reopen for business, many doctors and hospital administrators are calling for a quick return of health care to pre-pandemic levels. For months now, routine care has been postponed. Elective procedures big moneymakers were halted so that hospitals could divert resources to treating Covid-19 patients. Routine clinic visits were canceled or replaced by online sessions. This has resulted in grievous financial losses for hospitals and clinics. Medical practices have closed. Hospitals have been forced to furlough employees or cut pay.

Most patients, on the other hand, at least those with stable chronic conditions, seem to have done OK. In a recent survey, only one in 10 respondents said their health or a family members health had worsened as a result of delayed care. Eighty-six percent said their health had stayed about the same.

Admittedly, postponing health care had terrible health consequences for some patients with non-Covid-19 illnesses, such as those with newly diagnosed cancers that went untreated because outpatient visits were canceled, or because patients avoided going to the hospital out of fear of contracting the coronavirus. The spike in deaths in major cities like New York during the crisis almost certainly includes such patients.

Still, a vast majority of patients seem to have fared better than what most doctors expected. It will probably take years to understand why. Perhaps patients mitigated the harm of delayed care by adopting healthful behaviors, such as smoking less and exercising more. Perhaps the huge increases in stress were balanced out by other things, such as spending more time with loved ones.

However, there is a more troubling explanation to consider: Perhaps Americans dont require the volume of care that their doctors are used to providing.

It is well recognized that a substantial amount of health care in America is wasteful, accounting for hundreds of billions of dollars of the total health care budget. Wasteful care is driven by many forces: defensive medicine by doctors trying to avoid lawsuits; a reluctance on the part of doctors and patients to accept diagnostic uncertainty (which leads to more tests); the exorbitant prices that American doctors and hospitals charge, at least compared to what is charged in other countries; a lack of consensus about which treatments are effective; and the pervasive belief that newer, more expensive technology is always better.

One of the most significant factors in wasteful health care is having too much supply of health care per capita in certain areas. In specialist-heavy Miami-Dade County, for example, Medicare spends more than twice per person what it spends in Santa Fe, N.M., largely because there is more per capita utilization of doctors services. Sadly, more care doesnt always result in better outcomes.

If beneficial routine care dropped during the past few months of the pandemic lockdown, so perhaps did its malignant counterpart, unnecessary care. If so, this has implications for how we should reopen our health care system. Doctors and hospitals will want to ramp up care to make up for lost revenue. But this will not serve our patients needs.

The start-up should begin with a renewed commitment to promoting beneficial care and eliminating unnecessary care. Most doctors recognize the importance of this distinction, even if we dont always act on it. In a survey a few years ago, two-thirds of doctors in the United States admitted that between 15 percent and 30 percent of health care is probably unnecessary.

Medical societies already produce lists of procedures that are essential and those that are better avoided. The latter include M.R.I. scans for most lower-back pain and nuclear stress tests when there are no signs of heart disease. As hospitals and clinics reopen for non-Covid-19 care, such lists should be more widely publicized.

Patients have an important role to play, too. Studies suggest that up to 20 percent of surgeries in some specialties are unnecessary. If your surgery was postponed because of the pandemic, it is worth having a conversation with your doctor about whether it is still needed. Despite the complexity of disease today, ailments sometimes do get better by themselves. And in some cases, scheduled surgeries werent necessary in the first place.

Many institutions are using this difficult time in our nations history to make changes. The health care system should do the same. The pandemic has given us a glimpse of a world in which business as usual in our health care system was upended. It has also provided an opportunity to start up again in a healthier and more financially responsible way. Reflexively returning to the status quo may be good for our bottom line, but it wont serve our patients well.

Sandeep Jauhar (@sjauhar) is a cardiologist, a contributing Opinion writer and the author, most recently, of Heart: A History.

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How Should We Reopen Hospitals That Closed Because of the Coronavirus? - The New York Times

The news in the US has been dominated by anti-racism protests for the past couple of weeks, but coronavirus is now back in the headlines.

Several states have seen a record number of cases in recent days, leading to fears that the country is experiencing a second wave of infections.

But Vice-President Mike Pence said those fears were "overblown" and accused the media of using "grim predictions" to scare the American people.

So what is going on in the US?

With more than two million coronavirus cases, the US has the highest number of confirmed infections in the world - about a quarter of the global total.

The situation got really bad in late March but by May, cases were declining and most states had begun to ease restrictions put into place to halt the spread of the virus.

The number of new cases rarely fell below 20,000 though, because as some states were bringing their outbreaks under control, others were only just beginning to see flare-ups.

For this reason, the top US health official for infectious diseases, Anthony Fauci, sees the current situation as a continuation of the initial outbreaks.

"People keep talking about a second wave," he told a reporter last week. "We're still in a first wave."

Spikes in cases in those new hotspots mean the country's overall seven-day average has now risen for several days in a row for the first time since cases peaked in early April.

The North East has been by far the worst-hit region, with about a quarter of all US cases and more than a third of all US deaths occurring in the states of New York and New Jersey. But in recent weeks, the region has brought its outbreaks under control.

The South and West of the country, on the other hand, have seen a big rise in the number of infections, according to data compiled by the COVID Tracking Project.

There's no debate over whether cases are going up again, but there is over why.

President Donald Trump blames it on increased testing, telling the Wall Street Journal he thinks "testing is overrated" because "in many ways, it makes us look bad."

The US has conducted more tests than any other country - about 25 million so far - so that does go some way to explaining why it has the highest number of cases in the world, although international comparisons are difficult to make for a number of reasons.

But there's plenty of evidence to suggest the recent rise in infections is down to more than just a higher number of people being tested.

Twice last week, Arizona saw more new cases on its own than the entire nine-state North East region and that's not just down to increased testing.

This is clear when you look at the rate of coronavirus tests that are coming back positive.

If lots of tests are being done and the spread of the virus has been reduced, then the positive case rate would go down too. If the virus is still being spread widely, it goes up.

At the moment the positive case rate is just below 5% nationally, which is the level the World Health Organization recommends countries be at or below for 14 days before they ease restrictions on movement.

But about a third of states are above that level, as the chart below shows, and all of them have reopened to some extent over the last month.

The number of people being hospitalised has also risen in a number of these states, including Texas, where some reopened bars and restaurants are now closing their doors again, reports the Texas Tribune, because of fears over a new surge of cases.

Faced with rising case numbers and an economy that desperately needs to get going again, many public officials are looking to facemasks to help slow the spread of the virus. California, North Carolina and several US cities mandated or urged their use last week.

But masks have become increasingly politicised in recent weeks, with President Trump saying some people wear them primarily to show opposition to him.

Amid all of the fears about new hotspots, the most positive news in the US at the moment is that daily deaths continue to fall.

They peaked back in May when the outbreaks in the Northeast were at their most intense, with New York state alone registering around 1,000 a day. This week, that figure is about 40 a day.

However, deaths is a metric that lags behind cases and hospitalisations because it can take several weeks for those who are worst-hit to die from the disease. That means the consequences of the current spikes in cases won't be seen for a couple of weeks at least.

If we do see the number of deaths edging up, there will likely be some pressure on governors to reintroduce restrictions but Dr Fauci doesn't think that will happen.

"I don't think we're going to be talking about going back to lockdown," he said last week. "I think we're going to be talking about trying to better control those areas of the country that seem to be having a surge of cases."

Researchers are racing to produce a vaccine but it's clear that Americans, and the rest of the world, are going to be living with the virus until next year at the earliest.

So far, the US has recorded about 120,000 coronavirus deaths - the highest death toll in the world.

But one forecasting model run by experts at the University of Washington, which has been cited by the White House in the past, predicts that number will have passed 200,000 by October - a month before the election.

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Coronavirus: Is the pandemic getting worse in the US? - BBC News

When a deluge of coronavirus cases threatened to overwhelm the NHS in March, Covid-19 was a brand new and little-understood disease, causing panic as well as deaths. Hospitals under huge pressure did all they could.

Next time round, if, as everyone supposes, there is a next time, it will be different. In a second wave, or even localised spikes across the nation, the health service will know more about what it is dealing with and will be better able to help people recover and send them home, say doctors.

First, two drugs have been shown to work to some extent, even though neither is a cure. Most exciting is the revelation that a 60-year-old steroid, dexamethasone, reduces deaths among those who are most sick saving one in eight lives among those on ventilators and one in 25 of those on other oxygen support. Remdesivir is also useful, reducing the length of the illness.

Mervyn Singer, a professor of intensive care medicine at University College London, is delighted with the dexamethasone result. Covid-19 causes inflammation in the lungs and steroids are already used to reduce inflammation, but he said medicine is conservative with a small c, and some clinicians worried that they suppress the immune system, so they have generally been used later rather than earlier. However, the Recovery trial, a global trial into possible treatments, showed how well low-dose dexamethasone works in Covid-19 and it will now become standard of care.

He thinks medical staff will next time feel less anxious carrying out procedures such as intubation, which carries the risk of viral particles shooting into the air. They will also be happier about chest compression and humidification ventilating patients in a way that allows water vapour to emerge when they breathe.

We have become more confident in dealing with it. I think wed be much less paranoid about the risk of infection. Obviously we wear PPE but the people looking after the patients in intensive care have had a low level of infection no different from the man in the street which I think is important because there was a lot of fear, said Singer.

What helps now is the reduced numbers of patients in intensive care with breathing problems. Even in bad flu outbreaks, it was never like the peak numbers for Covid-19. Normally wed have two to three of these patients in an intensive care unit. We got up to 62 at one time, Singer said.

When you have got one nurse to one patient doing everything we normally do, its a very different kettle of fish from one nurse to four patients.

Epidemics of infectious diseases behave in different ways but the1918 influenza pandemicthat killed more than 50 million people is regarded as a key example of a pandemic that occurred in multiple waves, with the latter more severe than the first. It has been replicated albeit more mildly in subsequent flu pandemics.

How and why multiple-wave outbreaks occur, and how subsequent waves of infection can be prevented, has become a staple of epidemiological modelling studies and pandemic preparation, which have looked at everything from social behaviour and health policy to vaccination and the buildup of community immunity, also known as herd immunity.

Is there evidence of coronavirus coming back in a second wave?

This is being watched very carefully. Without a vaccine, and with no widespread immunity to the new disease, one alarm is being sounded by the experience of Singapore, which has seen a suddenresurgence in infectionsdespite being lauded for its early handling of the outbreak.

Although Singapore instituted a strong contact tracing system for its general population, the disease re-emerged incramped dormitory accommodationused by thousands of foreign workers with inadequate hygiene facilities and shared canteens.

Singapores experience, although very specific, has demonstrated the ability of the disease to come back strongly in places where people are in close proximity and its ability to exploit any weakness in public health regimes set up to counter it.

In June 2020, Beijing suffered from a new cluster of coronavirus cases which caused authorities to re-implement restrictions that CHina had previously been able to lift.

What are experts worried about?

Conventional wisdom among scientists suggests second waves of resistant infections occur after the capacity for treatment and isolation becomes exhausted. In this case the concern is that the social and political consensus supporting lockdowns is being overtaken by public frustration and the urgent need to reopen economies.

The threat declines when susceptibility of the population to the disease falls below a certain threshold or when widespread vaccination becomes available.

In general terms the ratio of susceptible and immune individuals in a population at the end of one wave determines the potential magnitude of a subsequent wave. The worry right now is that witha vaccine still many months away, and the real rate of infection only being guessed at, populations worldwide remain highly vulnerable to both resurgence and subsequent waves.

Peter Beaumont

Early on, he and colleagues at UCL realised fewer patients needed ventilation than had been forecast. The assumption that the UK would need 18,000 ventilators when it had 8,000 was one of the reasons it was thought the NHS would be unable to cope with the epidemic and that led to the lockdown.

But only half of the sickest patients were intubated and put on a machine, while just as many have been given other help with their breathing, such as with the use of a Cpap (continuous positive airway pressure) mask. The long-term outcomes are better.

Clinicians also now have more idea of which patients are likely to become sickest. There was a lot of talk earlier on about the cytokine storm triggered by the patients immune system going into overdrive and attacking its own cells. If you look at the data, it isnt particularly high, Singer said.

There is a hyper-inflammatory reaction from the body, but it manifests in a different way and can be measured by a standard inflammatory marker called C-reactive protein, or CRP. Its part of the bodys host response. It goes up hugely in Covid, whereas cytokine levels dont go up very much, he said.

It means a patients CRP level can be checked on arrival in hospital. It is the patients who are more hyper-inflamed who are more likely to die. We can target those patients more or less as they come through the door, said Singer.

One of the big and alarming surprises has been the damage Covid-19 does to the heart and circulatory system. There is a really increased risk of clotting, probably due to damage to the blood vessels, said Prof Sir Nilesh Samani, the medical director of the British Heart Foundation.

The virus attacks the lining of the blood vessels and makes them more likely to clot.

People who have had heart attacks or strokes are more vulnerable to the virus, which can also cause them in sick patients. The heart attacks are peculiar, said Samani. It is the smaller arteries downstream that are affected, where the inflammation is more acute.

One small study looking at the lungs of people who died, published in the New England Journal of Medicine, found they had nine times as many blood clots as people who died from swine flu (H1N1).

Knowing the danger, many hospitals are now giving those at risk anticoagulants and antiplatelet therapy soon after admission. These are drugs that thin the blood, making clotting less likely.

The lesson we have learned is that we should treat these people before they have the clot, said Samani. The risk can be measured by looking at the levels of D-dimers in the blood. These are proteins the leftovers from the normal clotting of blood when people have a wound that heals, for instance. But high levels can indicate a clot is forming.

The British Heart Foundation, together with the governments National Institute for Health Research, is supporting six major research programmes to discover more about the effects of the virus. These will combine data from hospitals, information about our health and lifestyle, genetic studies, and imaging and artificial intelligence techniques.

That research, and much more in other fields, will help find the optimal way to treat Covid-19 patients and reduce the death rate when and if it returns.

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Why doctors say UK is better prepared for a second wave of coronavirus - The Guardian

As we see the return of the sunshine this week, and as the number of confirmed cases and deaths in the UK continues to fall, it can feel as if the worst of the pandemic is over.

Far from relaxing, the government should be using this respite to make long-term plans on how to coexist with the virus until a vaccine can be found. Time is running out when the cold and damp weather sets in, the virus will thrive. Test, trace and isolate schemes will be stretched as soon as flu symptoms rise and overlap with Covid-19 symptoms. Avoiding a second lockdown must be the imperative to ensure that the sacrifices made by the British public over the past 13 weeks do not go to waste.

Currently the governments drive to open up as quickly as possible bears a risk of another increase in infections, similar to what is being experienced in several US states such as Florida, Arizona and Texas, and in Iran. Ian Diamond, the UKs national statistician, warned that the UK currently faces 3,000-4,000 new infections per day and only a fraction of those are being picked up through the test and protect scheme. By allowing the virus to spread during the summer months the government is creating a ticking time bomb that will go off as autumn arrives.

Covid-19 is too dangerous to let spread through a population unchecked. Not only because of the difficulty of staying within health service capacity and overall mortality, but also because of the morbidity it entails. The FT has estimated that 65,000 excess deaths have occurred so far during the Covid-19 pandemic in the UK. In addition, an increasing number of long-term health complications are being seen in those who have recovered from the virus, and often in those who were healthy previously. Covid-19 is not the flu, but a multi-system disease that has surprised doctors in how it presents and how it develops within the human body. Important questions about immunity remain about whether re-infection is possible, or even immune enhancement where individuals get a more severe version of the same virus upon repeated exposure, such as with dengue fever.

That is not to say countries should remain in lockdown until a vaccine is discovered, given the economic and social costs. Instead, each country will need to find the least worst path out of this situation based on their populations, public health system and capacity. An increasing number of countries are trying to suppress the virus to a low level and, where possible, eliminate it before reopening their schools, shops and restaurants. Not only New Zealand, but also Australia, Thailand, Vietnam, the Faroe Islands, Iceland and countries in east Asia. Once the virus has all but disappeared, governments in these nations are able to identity imported cases such as the two British travellers who reintroduced Covid-19 to New Zealand and limit their spread. It is possible to both eliminate the virus and reopen economies but it has to be done cautiously and with close monitoring.

As an island, Great Britain is in a strong position to eliminate the virus and fully reopen schools, bars and theatres as well as bringing back sports matches and weddings, without pointless debates about 1 or 2 metre distancing measures. This would require mass testing to catch all symptomatic and asymptomatic carriers tracing of contacts and isolation for those individuals. The public needs to be convinced that the short-term pain is worth it, including continued physical distancing from others, use of face masks when distancing is not possible, and putting aside short-term self-interest for a few more months. Local dashboards should be created using the first part of postcodes, so individuals can understand transmission within their communities and ensure their behaviour contributes to a downwards push. Covid-19 will burn itself out if it has no other hosts to transmit it.

A clear push towards a zero coronavirus Britain should have been the priority when the country went into late lockdown on 23 March. And while other countries raced ahead with testing and tracing, and border control, and face masks, the UK government seemed to think that locking down alone was the solution, instead of a window of extremely costly time to aggressively go after the virus and drive it out. As a Chinese colleague told me in early March, implement key public health measures now and youll be out of the woods by mid-June.

The UK government has missed chance after chance to suppress this virus and reopen the economy as quickly as possible. The summer months offer it a narrow timeframe to reassess its overall strategy in managing this outbreak. It feels like decisions are being made based on polling to see how this affects government approval ratings, rather than based on what is needed to get through this crisis. Planning and leadership are required to look at where the country needs to be, then work back from that to implement the key measures to get there. All of our lives, jobs and futures depend on it.

Prof Devi Sridhar is chair of global public health at the University of Edinburgh

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The pandemic is not over we need to push now for a zero-coronavirus Britain - The Guardian