Daily Archives: July 3, 2020

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WASHINGTON, D.C. -- As coronavirus infections are spiking in U.S. states that previously had not been hard-hit, a new high of 65% of U.S. adults say the coronavirus situation is getting worse. The percentage of Americans who believe the situation is getting worse has increased from 48% the preceding week, and from 37% two weeks prior.

Line graph. A new high of 65% of US adults say the coronavirus situation in the U.S. is getting worse. 23% say it is getting better.

The latest results, from June 22-28, are based on Gallup's online COVID-19 tracking survey, which interviews weekly random samples from Gallup's probability-based panel. Last week, governors in many states paused or rolled back plans to ease restrictions on economic activity as states in the South and West dealt with a surge in coronavirus infections and hospitalizations.

Gallup first asked Americans in early April to say whether they thought the coronavirus situation was getting better or worse. At that time, 56% said it was getting worse and 28% better, the most negative assessment prior to the latest reading. From late April through early June, there were several weeks in which more Americans said the situation was getting better than getting worse.

Today, there is widespread agreement among Americans in all parts of the country that the situation is getting worse. Between 62% and 68% of those living in the four major regions of the U.S. say it is worsening. These rates represent heightened concern over the prior week in all four regions, including increases of 13 percentage points for those living in the South and Midwest, 19 points for those in the West and 22 points for those in the Northeast.

Additionally, all major party groups are more inclined than they were the previous week to see the situation as getting worse, including an eight-point increase among Republicans, 18 points among independents and 15 points among Democrats. But the partisan gap remains vast, as 90% of Democrats, 63% of independents and 28% of Republicans believe the situation is getting worse. A majority of Republicans, 54%, say the situation is getting better.

Americans' greater pessimism is also apparent in the 74% who expect the level of disruption to travel, school, work and public events in the U.S. to persist through the end of this year (37%) or beyond that (37%). This represents a 10-point increase from the prior week in the percentage of U.S. adults who think the coronavirus situation will last at least until the end of the year. In early May, less than half of Americans expected the situation to last that long.

Line graph. Nearly three quarters of Americans expect the disruption brought about the coronavirus will last until the end of the year or longer than that. Nineteen percent believe it will last a few more months and 7% say it will last a few more weeks.

Ninety percent of Democrats, 75% of independents and 48% of Republicans expect disruptions to continue through the end of the year or longer.

The percentage of Americans who say they are very or somewhat worried about getting the coronavirus has increased from 48% to 56%, a level not seen since late April. It is also one point off the trend's record high of 57%, registered in the initial measurement the week of April 6-12.

A majority of 56% of Americans are worried about getting the coronavirus.

Worry about getting the virus has increased most among Northeastern residents (up 19 points, to 60%) and Western residents (up 15 points, to 58%), with little change among those living in the Midwest or South.

Democrats (74%) remain far more worried about getting COVID-19 than independents (50%) or Republicans (30%) -- but Republicans show the greatest increase in worry compared with the prior week, up from 22%.

The poll also finds a significant increase in the percentage of Americans who say the better advice for healthy people is to stay home as much as possible. Seventy-two percent now hold this view, up from 66% the previous week. This is the first time since the initial measurement of this question in late March -- during the initial surge in U.S. cases -- that there has been a meaningful increase in the percentage who say it is better for healthy people to stay home. Still, it remains lower than the 91% who advocated that course of action in March.

Twenty-eight percent now hold the opposing view -- that it is better for healthy people to lead their normal lives as much as possible to avoid interruptions to work and business.

Line graph. Seventy-two percent of Americans, up from 66%, a week ago, say the better advice for healthy people is to stay home as much as possible. Twenty eight percent say the better advice is to for healthy people to lead their normal lives as much as possible.

Relatedly, fewer Americans now (25%) than the prior week (32%) say they would resume their normal day-to-day activities "right now" if it were up to them. About the same percentage, 26%, now say they would resume their normal activities after the number of cases in their state declines significantly. This leaves about half of Americans indicating they would be more cautious about returning to normal -- with 30% saying they would do so when there are no new cases in their state, and 19% waiting for the development of a vaccine.

Americans may dispute whether the recent increase in new daily coronavirus cases represents a continuation of the first wave or the start of a second wave of infections -- but there is a growing public consensus that the situation is getting worse. An increase in new daily cases was not unexpected as business restrictions were eased, but the size of the increase in states like California, Texas, Florida and Arizona has caused governors there to rethink the pace of loosening those restrictions, if not reverse course on some of them.

The recent developments are a grim reminder that even as the number of new daily cases declined in recent months, the virus never went away. Consequently, Americans are increasingly likely to think the disruptions to daily life will persist in the U.S. through at least the end of this year.

Learn more about how the Gallup Panel works.

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Assessment of US COVID-19 Situation Increasingly Bleak - Gallup

Carson City Health and Human Services

Carson City Health and Human Services is reporting seven new positive cases and three additional recoveries of COVID-19 in the Quad-County region on Thursday, July 2, 2020. This brings the total number of cases to 361, with 258 recoveries, seven deaths and 96 cases active.

The new cases are: A male Lyon County resident under the age of 18 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-166 Total (+5 from 7/1)-47 Active (+3 from 7/1)-114 Recovered (+2 from 7/1)-5 Deaths

Douglas County-70 Total (+0 from 7/1)-20 Active (+0 from 7/1)-50 Recovered (+0 from 7/1)

Lyon County-123 Total (+2 from 7/1)-28 Active (+1 from 7/1)-93 Recovered (+1 from 7/1)- 2 Deaths

Storey County-2 Total (+0 from 7/1)-1 Active (+0 from 7/1)-1 Recovery (+0 from 7/1)

TOTAL-361 Total Cases (+7 from 7/1)-96 Active (+4 from 7/1)-253 Recovered (+3 from 7/1)-7 Deaths (+0 from 7/1)-10 Hospitalizations (+0 from 7/1)

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

Fourth of July Holiday CelebrationsWith the Fourth of July holiday weekend approaching, CCHHS wants to remind everyone to continue following preventative actions such as keeping 6 feet of space between you and others, wearing a face covering, washing your hands often with soap and water for 20 seconds, staying home in you are sick, and avoiding large group gatherings to slow the spread of COVID-19.

If you are planning to host a small group gathering to celebrate the holiday, host it outdoors if possible. Remind guests to stay home if they are sick and keep a list of attendees in case it is needed for contact tracing purposes in the future. Require guests to wear a cloth face covering and encourage them to bring their own food and beverages.

More tips can be found at https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/personal-soc...

In observance of Independence Day, the Quad-County COVID-19 Hotline will be closed Friday July 3 and Saturday July 4. It will reopen Monday July 6 at 8 a.m. The phone number is (775) 283-4789.Stay informed.

For updates and more information on COVID-19 visit https://gethealthycarsoncity.org/novel-coronavirus-2019/

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Quad area COVID-19 briefing for July 2: Five new Carson City cases, 2 in Lyon; 3 recoveries - Carson Now

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In addition to the selected guidance included below, all of WHOs technical guidance on COVID-19 can be found online here.

All events listed below are in the Geneva, Switzerland time zone (CET/CEST). Note that the dates listed for documents are based on when they were finalised and timestamped.

WHOs Country Office in the Peoples Republic of China picked up a media statement by the Wuhan Municipal Health Commission from their website on cases of viral pneumonia in Wuhan, Peoples Republic of China.

The Country Office notified the International Health Regulations (IHR) focal point in the WHO Western Pacific Regional Office about the Wuhan Municipal Health Commission media statement of the cases and provided a translation of it.

WHOs Epidemic Intelligence from Open Sources (EIOS) platform also picked up a media report on ProMED (a programme of the International Society for Infectious Diseases) about the same cluster of cases of pneumonia of unknown cause, in Wuhan.

Several health authorities from around the world contacted WHO seeking additional information.

WHO requested information on the reported cluster of atypical pneumonia cases in Wuhan from the Chinese authorities.

WHO activated its Incident Management Support Team (IMST), as part of its emergency response framework, which ensures coordination of activities and response acrossnthe three levels of WHO (Headquarters, Regional, Country) for public health emergencies.

The WHO Representative in China wrote to the National Health Commission, offering WHO support and repeating the request for further information on the cluster of cases.

WHO informed Global Outbreak Alert and Response Network (GOARN) partners about the cluster of pneumonia cases in the Peoples Republic of China. GOARN partners include majornpublic health agencies, laboratories, sister UN agencies, international organizations and NGOs.

Chinese officials provided information to WHO on the cluster of cases of viral pneumonia of unknown cause identified in Wuhan.

WHO tweeted that there was a cluster of pneumonia cases with no deaths in Wuhan, Hubei province, Peoples Republic of China, and that investigations to identify the cause were underway.

WHO shared detailed information about a cluster of cases of pneumonia of unknown cause through the IHR (2005) Event Information System, which is accessible to all Member States. The event notice provided information on the cases and advised Member States to take precautions to reduce the risk of acute respiratory infections.

WHO also issued its first Disease Outbreak News report. This is a public, web-based platform for the publication of technical information addressed to the scientific and public health communities, as well as global media. The report contained information about the number of cases and their clinical status; details about the Wuhan national authoritys response measures; and WHOs risk assessment and advice on public health measures. It advised that WHOs recommendations on public health measures and surveillance of influenza and severe acute respiratory infections still apply.

WHO reported that Chinese authorities have determined that the outbreak is caused by a novel coronavirus.

WHO convened the first of many teleconferences with global expert networks, beginning with the Clinical Network.

The Global Coordination Mechanism for Research and Development to prevent and respond to epidemics held its first teleconference on the novel coronavirus, as did the Scientific Advisory Group of the research and development (R&D) Blueprint, a global strategy and preparedness plan that allows the rapid activation of research and development activities during epidemics.

The Director-General spoke with the Head of the National Health Commission of the Peoples Republic of China. He also had a call to share information with the Director of the Chinese Center for Disease Control and Prevention.

WHO published a comprehensive package of guidance documents for countries, covering topics related to the management of an outbreak of a new disease:

Chinese media reported the first death from the novel coronavirus.

WHO convened the first teleconference with the diagnostics and laboratories global expert network.

The Ministry of Public Health in Thailand reported an imported case of lab-confirmed novel coronavirus from Wuhan, the first recorded case outside of the Peoples Republic of China.

WHO publishes first protocol for a RT-PCR assay by a WHO partner laboratory to diagnose the novel coronavirus.

14 January 2020

WHO held a press briefing during which it stated that, based on experience with respiratory pathogens, the potential for human-to-human transmission in the 41 confirmed cases in the Peoples Republic of China existed: it is certainly possible that there is limited human-to-human transmission.

WHO tweeted that preliminary investigations by the Chinese authorities had found no clear evidence of human-to-human transmission. In its risk assessment, WHO said additional investigation was needed to ascertain the presence of human-to-human transmission, modes of transmission, common source of exposure and the presence of asymptomatic or mildly symptomatic cases that are undetected.

The Japanese Ministry of Health, Labour and Welfare informed WHO of a confirmed case of a novel coronavirus in a person who travelled to Wuhan. This was the second confirmed case detected outside of the Peoples Republic of China. WHO stated that considering global travel patterns, additional cases in other countries were likely.

The Pan American Health Organization/WHO Regional office for the Americas (PAHO/AMRO) issued its first epidemiological alert on the novel coronavirus. The alert included recommendations covering international travellers, infection prevention and control measures and laboratory testing.

WHO convened the first meeting of the analysis and modelling working group for the novel coronavirus.

The WHO Western Pacific Regional Office (WHO/WPRO) tweeted that, according to the latest information received and WHO analysis, there was evidence of limited human-to-human transmission.

WHO published guidance on home care for patients with suspected infection.

WHO conducted the first mission to Wuhan and met with public health officials to learn about the response to the cluster of cases of novel coronavirus.

WHO/WPRO tweeted that it was now very clear from the latest information that there was at least some human-to-human transmission, and that infections among health care workers strengthened the evidence for this.

The United States of America (USA) reported its first confirmed case of the novel coronavirus. This was the first case in the WHO Region of the Americas.

WHO convened the first meeting of the global expert network on infection prevention and control.

The WHO mission to Wuhan issued a statement saying that evidence suggested human-to-human transmission in Wuhan but that more investigation was needed to understand the full extent of transmission.

The WHO Director-Generalconvenedan IHR Emergency Committee (EC) regarding the outbreak of novel coronavirus. The EC was comprised of 15 independent experts from around the world and was charged with advising the Director-General as to whether the outbreak constituted a public health emergency of international concern (PHEIC).

The Committee was not able to reach a conclusion on 22 January based on the limited information available. As the Committee was not able to make a recommendation, the Director-General asked the Committee to continue its deliberations the next day. The Director-General held a media briefing on the novel coronavirus, to provide an update on the Committees deliberations.

The EC met again on 23 January and members were equally divided as to whether the event constituted a PHEIC, as several members considered that there was still not enough information for it, given its restrictive and binary nature (only PHEIC or no PHEIC can be determined; there is no intermediate level of warning). As there was a divergence of views, the EC did not advise the Director-General that the event constituted a PHEIC but said it was ready to be reconvened within 10 days. The EC formulated advice for WHO, the Peoples Republic of China, other countries and the global community.

The Director-General accepted the advice of the Committee and held a second media briefing, giving a statement on the advice of the EC and what WHO was doing in response to the outbreak.

France informed WHO of three cases of novel coronavirus, all of whom had travelled from Wuhan. These were the first confirmed cases in the WHO European region (EURO).

WHO held an informal consultation on the prioritization of candidate therapeutic agents for use in novel coronavirus infection.

The Director of the Pan American Health Organization (PAHO) urged countries in the Americas to be prepared to detect early, isolate and care for patients infected with the new coronavirus, in case of receiving travelers from countries where there was ongoing transmission of novel coronavirus cases. The Director spoke at a PAHO briefing for ambassadors of the Americas to the Organization of American States (OAS) in Washington.

The WHO Regional Director for Europe issued a public statement outlining the importance of being ready at the local and national levels for detecting cases, testing samples and clinical management.

WHO released its first free online course on the novel coronavirus on its OpenWHO learning platform.

The WHO Regional Director for South-East Asia issued a press release that urged countries in the Region to focus on their readiness for the rapid detection of imported cases and prevention of further spread.

A senior WHO delegation led by the Director-General arrived in Beijing to meet Chinese leaders, learn more about the response in the Peoples Republic of China, and to offer technical assistance. The Director-General met with President Xi Jinping on 28 January, and discussed continued collaboration on containment measures in Wuhan, public health measures in other cities and provinces, conducting further studies on the severity and transmissibility of the virus, continuing to share data, and a request for China to share biological material with WHO. They agreed that an international team of leading scientists should travel to China to better understand the context, the overall response, and exchange information and experience.

On his return to Switzerland from China, the Director-General presented an update to Member States on the response to the outbreak of novel coronavirus infection in China, at the 30th Meeting of the Programme, Budget and Administration Committee (PBAC) of the Executive Board. He informed the PBAC that he had reconvened the Emergency Committee on the novel coronavirus under the IHR (2005), which would meet the following day to advise on whether the outbreak constituted a PHEIC.

The Director-General also held a press briefing on his visit to China and announced the reconvening of the EC the next day. The Director-General based the decision to reconvene on the deeply concerning continued increase in cases and evidence of human-to-human transmission outside China, in addition to the numbers outside China holding the potential for a much larger outbreak, even though they were still relatively small. The Director-General also spoke of his agreement with President Xi Jinping that WHO would lead a team of international experts to visit China as soon as possible to work with the government on increasing the understanding of the outbreak, to guide global response efforts.

WHO held the first of its weekly informal discussions with a group of public health leaders from around the world, in line with its commitment to conducting listening exercises and outreach beyond formal mechanisms.

The United Arab Emirates reported the first cases in the WHO Eastern Mediterranean Region. The Regional Director affirmed that the Regional Office continued to monitor disease trends and work with Member States to ensure the ability to detect and respond to potential cases.

The Pandemic Supply Chain Network (PSCN) created by WHO, in collaboration with the World Economic Forum, held its first meeting. The mission of PSCN is to create and manage a market network allowing for WHO and private sector partners to access any supply chain functionality and asset from end-to-end anywhere in the world at any scale.

WHO published advice on the use of masks in the community, during home care and in health care settings.

WHO held a Member State briefing to provide more information about the outbreak.

The WHO Director-General reconvened the IHR Emergency Committee (EC).

The EC advised the Director-General that the outbreak now met the criteria for a PHEIC. The Director-General accepted the ECs advice and declared the novel coronavirus outbreak a PHEIC. At that time there were 98 cases and no deaths in 18 countries outside China. Four countries had evidence (8 cases) of human-to-human transmission outside China (Germany, Japan, the United States of America, and Viet Nam).

The EC formulated advice for the Peoples Republic of China, all countries and the global community, which the Director-General accepted and issued as Temporary Recommendations under the IHR. The Director-General gave a statement, providing an overview of the situation in China and globally; the statement also explained the reasoning behind the decision to declare a PHEIC and outlined the EC's recommendations.

WHOs Regional Director for Africa sent out a guidance note to all countries in the Region emphasising the importance of readiness and early detection of cases.

First dispatch of RT-PCR lab diagnostic kits shipped to WHO Regional Offices.

WHO finalised its Strategic Preparedness and Response Plan (SPRP), centred on improving capacity to detect, prepare and respond to the outbreak. The SPRP translated what had been learned about the virus at that stage into strategic action to guide the development of national and regional operational plans. Its content is structured around how to rapidly establish international coordination, scale up country preparedness and response operations, and accelerate research and innovation.

The WHO Director-General asked the UN Secretary-General to activate the UN crisis management policy, which held its first meeting on 11 February.

During the 146th Executive Board, WHO held a technical briefing on the novel coronavirus. In his opening remarks, the Director-General urged Member States to prepare themselves by taking action now, saying We have a window of opportunity. While 99% of cases are in China, in the rest of the world we only have 176 cases.

Responding to a question at the Executive Board, the Secretariat said, it is possible that there may be individuals who are asymptomatic that shed virus, but we need more detailed studies around this to determine how often that is happening and if this is leading to secondary transmission.

WHO's headquarters began holding daily media briefings on the novel coronavirus, the first time that WHO has held daily briefings by the Director-General or Executive Director of the WHO Health Emergencies Programme.

WHO deployed an advance team for the WHO-China Joint Mission, having received final sign-off from the Peoples Republic of China that day. The mission had been agreed between the Director-General and President Xi Jinping during the WHO delegations visit to China at the end of January. The advance team completed five days of intensive preparation for the Mission, working with Chinas National Health Commission, the Chinese Center for Disease Control and Prevention, local partners and related entities and the WHO China Country Office.

WHO announced that the disease caused by the novel coronavirus would be named COVID-19. Following best practices, the name of the disease was chosen to avoid inaccuracy and stigma and therefore did not refer to a geographical location, an animal, an individual or group of people.

WHO convened a GlobalResearch and Innovation Forum on the novel coronavirus, attended in person by more than 300 experts and funders from 48 countries, with a further 150 joining online.Participants came together to assess the level of knowledge, identify gaps and work together to accelerate and fund priority research, with equitable access as a fundamental principle underpinning this work.

Topics covered by the Forum included: the origin of the virus, natural history, transmission, diagnosis; epidemiological studies; clinical characterization and management; infection prevention and control; R&D for candidate therapeutics and vaccines; ethical considerations for research; and the integration of the social sciences into the outbreak response.

The Forum was convened in line with the WHO R&D Blueprint, which was activated to accelerate diagnostics, vaccines and therapeutics for this novel coronavirus.

Supplementing the SPRP with further detail, WHO published Operational Planning Guidelines to Support Country Preparedness and Response, structured around the eight pillars of country-level coordination, planning, and monitoring; risk communication and community engagement; surveillance, rapid response teams, and case investigation; points of entry; national laboratories; infection prevention and control; case management; and operational support and logistics. These guidelines operationalised technical guidance, such as that published on 10-12 January.

WHOs Digital Solutions Unit convened a roundtable of 30 companies in Silicon Valley to help build support for WHO to keep people safe and informed about COVID-19.

Based on lessons learned from the H1N1 and Ebola outbreaks, WHO finalised guidelines for organizers of mass gatherings, in light of COVID-19.

The Director-General spoke at the Munich Security Conference, a global forum dedicated to issues of international security, including health security, where he also held several bilateral meetings

In his speech, the Director-General made three requests of the international community: use the window of opportunity to intensify preparedness, adopt a whole-of-government approach and be guided by solidarity, not stigma. He also expressed concern at the global lack of urgency in funding the response.

The WHO-China Joint Mission began its work. As part of the mission to assess the seriousness of this new disease; its transmission dynamics; and the nature and impact of Chinas control measures, teams made field visits to Beijing, Guangdong, Sichuan and Wuhan.

The Mission consisted of 25 national and international experts from the Peoples Republic of China, Germany, Japan, the Republic of Korea, Nigeria, the Russian Federation, Singapore, the United States of America and WHO, all selected after broad consultation to secure the best talent from a diversity of geographies and specialties. It was led by a Senior Advisor to the WHO Director-General, with the Head of Expert Panel of COVID-19 Response at the China National Health Commission (NHC) as co-lead.

Throughout the global outbreak, WHO has regularly sent missions to countries to learn from and support responses, at the request of the affected Member State. Particularly in the early stages of the worldwide COVID-19 response, missions went to countries facing relatively high levels of community transmission, such as the Islamic Republic of Iran, Italy, and Spain.

Weekly WHO Member State Briefings on COVID-19 began, to share the latest knowledge and insights on COVID-19.

The WHO Director-General appointed six special envoys on COVID-19, to provide strategic advice and high-level political advocacy and engagement in different parts of the world:

The Team Leaders of the WHO-China Joint Mission on COVID-19 held a press conference to report on the main findings of the mission.

The Mission warned that "much of the global community is not yet ready, in mindset and materially, to implement the measures that have been employed to contain COVID-19 in China.

The Mission stressed that to reduce COVID-19 illness and death, near-term readiness planning must embrace the large-scale implementation of high-quality, non-pharmaceutical public health measures, such as case detection and isolation, contact tracing and monitoring/quarantining and community engagement.

Major recommendations were developed for the Peoples Republic of China, countries with imported cases and/or outbreaks of COVID-19, uninfected countries, the public and the international community. For example, in addition to the above, countries with imported cases and/or outbreaks were recommended to "immediately activate the highest level of national Response Management protocols to ensure the all-of-government and all-of-society approach needed to contain COVID-19".

Success was presented as dependent on fast decision-making by top leaders, operational thoroughness by public health systems and societal engagement.

In addition to the Mission press conference, WHO published operational considerations for managing COVID-19 cases and outbreaks on board ships, following the outbreak of COVID-19 during an international voyage.

Confirmation of the first case in WHO's African Region, in Algeria. This followed the earlier reporting of a case in Egypt, the first on the African continent. The Regional Director for Africa called for countries to step up their readiness.

WHO published guidance on the rational use of personal protective equipment, in view of global shortages. This provided recommendations on the type of personal protective equipment to use depending on the setting, personnel and type of activity.

The Report of the WHO-China Joint Mission was issued, as a reference point for countries on measures needed to contain COVID-19.

WHO published considerations for the quarantine of individuals in the context of containment for COVID-19. This described who should be quarantined and the minimum conditions for quarantine to avoid the risk of further transmission.

WHO issued a call for industry and governments to increase manufacturing by 40 per cent to meet rising global demand in response to the shortage of personal protective equipment endangering health workers worldwide.

This call fits within a broader scope of ongoing engagement with industry, through WHOs EPI-WIN network and via partners, such as the International Chamber of Commerce and World Economic Forum, the latter of which has supported COVID-19 media briefings at the regional level.

WHO published the Global Research Roadmap for the novel coronavirus developed by the working groups of the Research Forum.

The Roadmap outlines key research priorities in nine key areas. These include the natural history of the virus, epidemiology, diagnostics, clinical management, ethical considerations and social sciences, as well as longer-term goals for therapeutics and vaccines.

To mark the number of confirmed COVID-19 cases surpassing 100 000 globally, WHO issued a statement calling for action to stop, contain, control, delay and reduce the impact of the virus at every opportunity.

WHO issued a consolidated package of existing guidance covering the preparedness, readiness and response actions for four different transmission scenarios: no cases, sporadic cases, clusters of cases and community transmission.

The Global Preparedness Monitoring Board, an independent high-level body established by WHO and the World Bank, responsible for monitoring global preparedness for health emergencies, called for an immediate injection of $8 billion for the COVID-19 response to: support WHO to coordinate and prioritize support efforts to the most vulnerable countries; develop new diagnostics, therapeutics, and vaccines; strengthen unmet needs for regional surveillance and coordination; and to ensure sufficient supplies of protective equipment for health workers.

WHO, UNICEF and the International Federation of Red Cross and Red Crescent Societies (IFRC) issued guidance outlining critical considerations and practical checklists to keep schools safe, with tips for parents and caregivers, as well as children and students themselves.

Deeply concerned both by the alarming levels of spread and severity, and by the alarming levels of inaction, WHO made the assessment that COVID-19 could be characterized as a pandemic.

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Timeline of WHO's response to COVID-19 - World Health Organization

A retrospective study of 57 adult COVID-19 patients published yesterday in Respiratory Research found significant lung impairment in the recovery phase, particularly in patients with severe disease.

Researchers conducted serial assessments of patients 30 days after they were released from the Fifth Affiliated Hospital of Sun Yat-sen University in Zhuhai, China. They found that, of the 40 non-severe and 17 severe cases, 31 patients (54.4%) still had abnormal findings on chest computed tomography (CT). The rate of abnormalities was much higher in severe (16 or 17, or 94.1%) than in mild illness (15/ 31, 37.5%).

Forty-three (75.4%) of the 57 patients had abnormal pulmonary function tests. The percent of patients who had results less than 80% of predicted values was 10.5% for forced vital capacity (FVC, amount of air forcibly exhaled after taking a deep breath), 8.7% for forced expiratory volume (FEV1, amount of air forcibly expelled in 1 second), 43.8% for FEV1/FVC ratio, 12.3% for total lung capacity (TLC), and 52.6% for diffusing capacity for carbon monoxide (DLCO) (amount of oxygen traveling from lungs to the blood).

Twenty-eight (49.1%) and 13 patients (22.8%) had maximum inspiratory pressure and maximum expiratory pressure values less than 80% of predicted values an indication of weakened respiratory muscles.

Twenty-six patients (86.7%) had mildly impaired DLCO, while the other 4 (13.3%) had moderate impairment. There was a significant difference in impaired DLCO between the two groups, accounting for 42.5% of patients with mild disease and 75.6% of those with severe illness.

Patients with severe COVID-19 had more DLCO impairment than those with less severe disease (75.6% vs 42.5%,P=0.019), as well as higher lung total severity scores (TSS) and total airway resistance and significantly lower percentage of predicted TLC and 6-minute walking distance (6MWD). The 6MWD of patients with severe illness was only 88.4% of predicted values, significantly lower than in those with mild illness.

Most patients in the severe group (70.6%) were men and were older than patients with milder disease. No significant correlation between TSS and pulmonary function was evident at follow-up.

Mean ratio of partial pressure of oxygen (Pa02) to fraction of inspired oxygen (FiO2) was significantly lower in patients with milder illness than in those with severe disease. Pa02 reflects how well oxygen is able to travel from the lungs to the blood, while FiO2 is the percentage of oxygen inhaled.

Patients with severe COVID-19 had higher serum lactate dehydrogenase (indicating tissue damage), C-reactive protein peaks (indicating inflammation), and lower counts of infection-fighting lymphocytes than those with milder illnesses. No significant differences were found in values of white blood cells, creatinine kinase (measuring muscle inflammation), lactic acid peaks (measures of levels of oxygen in the muscles), or length of hospital stay between the two groups.

At 30-day follow-up, 6 of 57 patients (10.5%) reported a mild cough, 4 (7.0%) had shortness of breath, and 3 (5.3%) said they sometimes wheezed.

Of 57 patients, 46 (80.7%) had a history of direct contact with Wuhan, Hubei province, the epicenter of China's coronavirus outbreak, while 9 (15.7%) had a history of smoking. Mean patient age was 47 years, and 31 patients were women.

Twenty-one patients (36.8%) had underlying illnesses, the most common of which were high blood pressure (11 patients), diabetes (4), cancer (3), and cardiovascular disease (3). All these conditions were either believed cured or well controlled at testing. None of the patients had a chronic respiratory disease.

The authors said they were surprised that the lung total severity score was not significantly correlated with FEV1, FVC, or DLCO, meaning that impaired lung function did not necessarily reflect severity of illness or changes on CT.

"We speculate that it was because most severe patients used glucocorticoid during hospitalization, suggesting that corticosteroids may improve the prognosis of patients with COVID-19," they wrote, cautioning that small sample size and selection bias may have affected the results. Corticosteroids are given to reduce inflammation.

The researchers called for future studies to include longer follow-up and exercise cardiopulmonary function testing.

More here:

Study finds lung impairment in recovering COVID-19 patients - CIDRAP

I was surprised like the rest of the world.

Its not every day you learn an animal in your backyard could protect humanity against the coronavirus. Sissy Sugarman thinks it might be a perfect fit for the three llamas living on her familys Sugar Sweet Farm, in Encinitas, however.

The llamas often protect the other smaller animals on the farm, Sugarman said.

They protect them against predators like coyotes and mountain lions that we have plenty of here in the valley, Sugarman said while feeding a carrot to a llama named Bandit.

The National Institute of Health said researchers in Belgium and the United States are studying antibodies found in llamas that have already proven to help fight other viruses like SARS.

There are two animals that have the antibody that they use to fight coronavirus, and thats llamas and sharks -- I wonder why they chose llamas to work with? Sugarman said, laughing.

Antibodies work as a blockade between a virus and cells, attaching to the virus and preventing its ability to attach to human cells.

It would be cool if they were able to protect humans as well, Sugarman said, feeding Bandit another carrot. Who would have thought llamas, of all things?

The NIH said if the llama antibodies prove to be effective, it would still be months before a vaccine was ready for humans.

Joe: Hey Boss, so, therere these llamas...Boss: Go.So, therere these llamas and they may save our lives. Im going to Sugar Sweet Farm to let them explain.NBC 7 at 4:30 and 6:00.

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Llamas May Hold the Key to COVID-19 - NBC San Diego

Victoria has announced 66 new cases of Covid-19 as the states health minister revealed Melbournes wave of new cases could potentially be traced back to a single super spreader of the virus.

On Tuesday, I received a briefing of a genomic sequencing report that seemed to suggest that there seems to be a single source of infection for many of the cases that have gone across the northern and western suburbs of Melbourne, the minister, Jenny Mikakos, said on Friday. It appears to be even potentially a super spreader that has caused this upsurge in cases.

The premier has previously stated that a significant portion of new cases are linked to breaches in the hotel quarantine system, which is now the subject of judicial inquiry.

We dont have the full picture yet, Mikakos said.

Not all of these cases have yet been subject to genomic sequencing. We need to enable that process to be completed and to be provided to the judicial inquiry in the fullness of time.

Deputy chief health officer Annalise van Dieman said the possibility of a super spreader was one of several possibilities.

This is a possible epidemiological theory about one of the things that may have caused this outbreak. There is not an identified super spreader at this point in time. It is one of the options, one of the possibilities, looking at the data, she said.

We dont have definitive evidence that it has been a single super spreader. What we have [is] evidence that the current outbreak is possibly looking more like what we call a point-source outbreak, where there was a tapering off of cases and then now the cases have gone up One of the possibilities that can do that is a person who is particularly infectious who attends multiple areas or multiple places.

On Friday, the Victorian premier, Daniel Andrews, said he was tentatively encouraged by a fourth day of stable case numbers.

While it may be too early for us to be talking about trends, a day with 66 is obviously far preferable to seeing a doubling and then a doubling again certainly, to see these numbers relatively consistent is very pleasing, he said.

Andrews declined to answer questions relating to his role in the decision by the government to use private security contractors rather than police or the Australian Defence Force to run hotel quarantine.

Ive not established a judicial inquiry chaired by a very well respected and highly qualified person to stand here and try to run her inquiry for her, he said. I understand why questions are asked the best way to answer those questions is to have a rigorous review, then provide a report with findings, with recommendations I am the leader of this government and Id take responsibility and have accountability for these and all matters.

More than 95,000 hotspot homes have now been knocked as part of the community testing blitz, but Miakaos said that disappointingly more than 10% of people have refused testings.

That might be for a range of reasons, including that they may have already been tested in a different location, she said.

We are analysing that data to see exactly why people are refusing, but it is concerning that some people believe that coronavirus is a conspiracy or that it wont impact on them, so what I want to stress here is that coronavirus is a very contagious virus. It can go through your family very quickly, it can affect your neighbours, your loved ones and your entire community.

Additional cases were added to the Al-Taqwa college cluster in Truganina, bringing the total to 23. The entire school, including all staff and students, have now been asked to quarantine for two weeks.

Cases were also added to the Stamford Plaza cluster and the Albanvale primary school cluster, along with additional close contacts from the Orygen youth mental health facility and the Villa Bambini childcare centre in Essendon.

Mikakos highlighted four postcodes with the highest rates of active cases as of Thursday night. These were 3,064 (Craigieburn, Donnybrook, Mickleham, Roxburgh Park and Kalkallo) with 52; 3,047 (Broadmeadows, Dallas, Jacana) with 25; and 3,060 (Fawkner) with 11.

The fourth postcode was 3031 (Flemington, Kensington), which is currently not a designated hotspot, but the deputy chief health officer said authorities would not be announcing further lockdowns today.

Any single days worth of data or cases in isolation is not necessarily going to be enough to cause lockdown or not, van Dieman said. Were going to looking at trends week by week and trends not based just on absolute numbers but also rates, as the premier mentioned.

The deputy chief health officer was asked on Friday why a NSW man who tested positive in Melbourne hotel quarantine was not tested a second time before being released and returning to Sydney.

There is a standard set of release from isolation criteria that is agreed upon nationally and it is consistent When a patient has had more than 10 days since the onset of symptoms, including 72 hours being symptom- and fever-free, they are released from isolation and clinically declared to be released from isolation, she said.

The reason that doesnt include a clearance test is because people can shed this virus, weeks to months, and the shedding virus is not the same as being infectious.

Van Dieman said she was confident the man did not pose a public health risk.

The man met the criteria and stayed for another two days on top of having the criteria because he was in hotel quarantine. He would have been released from any hotel quarantine in the country based on the criteria, including any hotel in Sydney with a person coming from Melbourne.

The NSW government has isolated more than 50 workers at the Balmain Woolworths supermarket, where the man worked while still displaying some symptoms. The NSW chief health officer, Kerry Chant, said it was unlikely the man was still infectious.

On Friday the ACT moved to make it a requirement that anyone travelling to the territory who is believed to have been in a hotspot must quarantine for 14 days at their own expense or return home immediately.

As national institutions reopen to the public in Canberra, the territory government has issued a new public health direction.

Anyone already in the ACT who has been in a Melbourne hotspot has been told to quarantine for two weeks, even if they do not have coronavirus symptoms. This is the first time during the pandemic that the ACT has closed its borders to anyone from Victoria.

People coming into Canberra from Melbourne must monitor themselves for signs of the virus and passengers on inbound flights must show identification on arrival. Anyone who refuses to comply will face fines.

Canberra residents have been told not to plan any visits to the Melbourne suburbs under a reinstated coronavirus lockdown, and to reconsider all non-essential travel to the city for the foreseeable future.

On Friday Andrews also announced a boost to funding for mental health care in order to support those in hotspot suburbs.

I can announce today just under $2m in additional funding, on top of the just under $60m we have already provided for targeted and localised mental health support for those who are really doing it very, very tough, he said. That extra funding will go to mental health service providers and mental health support, with a real focus on those hotspot suburbs.

On Friday Mikakos stressed it was permissible for residents in hotspot suburbs to leave their home to seek mental health support.

Andrews made a point of thanking the more than 300,000 people now in lockdown in the 36 hotspot suburbs across the city.

You are making enormous sacrifices its about your safety of course but its also about the safety of the entire state. And I cant say how grateful and how proud I am to think that people in those 10 postcodes are following the rules, are doing the right thing. From my government to you, for my family to yours, I say thank you. Thank you so very much.

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Victoria Covid-19: one 'super spreader' could be responsible for Melbourne spike in cases, government says - The Guardian

An experimental Covid-19 vaccine being developed by the drug giant Pfizer and the biotech firm BioNTech spurred immune responses in healthy patients, but also caused fever and other side effects, especially at higher doses.

The first clinical data on the vaccine were disclosed Wednesday in a paper released on medRXiv, a preprint server, meaning it has not yet been peer-reviewed or published in a journal.

We still have a ways to go and were testing other candidates as well, said Philip Dormitzer, the chief scientific officer for viral vaccines at Pfizers research laboratories. However, what we can say at this point is there is a viable candidate based on immunogenicity and early tolerability safety data.

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The study randomly assigned 45 patients to get one of three doses of the vaccine or placebo. Twelve received a 10-microgram dose, 12 a 30-microgram dose, 12 a 100-microgram dose, and nine a placebo. The 100-microgram dose caused fevers in half of patients; a second dose was not given at that level.

Following a second injection three weeks later of the other doses, 8.3% of the participants in the 10-microgram group and 75% of those in the 30-microgram group developed fevers. More than 50% of the patients who received one of those doses reported some kind of adverse event, including fever and sleep disturbances. None of these side effects was deemed serious, meaning they did not result in hospitalization or disability and were not life-threatening.

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The vaccine generated antibodies against SARS-CoV-2, the virus that causes Covid-19, and some of these antibodies were neutralizing, meaning that they appear to prevent the virus from functioning. Levels of neutralizing antibodies were 1.8 to 2.8 times the level of that in the recovered patients.

Its not certain that higher antibody levels will lead to immunity to the virus. To prove that, Pfizer will need to conduct large studies that aim to prove that people who have received the vaccine are at least 50% less likely to become infected. Those studies are expected to begin this summer, mostly in the United States. Pfizer and BioNTech are testing four different versions of the vaccine, but only one will advance to larger studies.

The current study did not include pregnant women, and no other information on the ethnic diversity of participants was noted, although the paper does say that future studies will need to include a more diverse group.

The second dose, a booster shot, was required for immunity. The patients who received the single 100-microgram dose had lower antibody levels than those who received two shots of the lower doses.

Fourteen Covid-19 vaccines are currently in human trials, according to the Milken Institute, including entrants from Inovio, CanSino, AstraZeneca, and Moderna. More are expected to start soon, including entrants from Merck, Johnson & Johnson, and Sanofi. In total, 178 vaccines are in various stages of development.

The Pfizer/BioNTech vaccine, like the Moderna vaccine, is based on a technology called messenger RNA, which uses a key genetic messenger found in cells to create protein that the immune system then learns to attack. Moderna has not yet published data on its vaccine but is expected to do so soon.

Excerpt from:

Covid-19 vaccine from Pfizer and BioNTech shows positive results - STAT

Treasury Secretary Steven Mnuchin gestures toward Federal Reserve Board Chairman Jerome Powell, as they appear before a House Committee on Financial Services hearing on oversight of the Treasury Department and Federal Reserve pandemic response, on Tuesday in Washington. Bill O'Leary/AP hide caption

Treasury Secretary Steven Mnuchin gestures toward Federal Reserve Board Chairman Jerome Powell, as they appear before a House Committee on Financial Services hearing on oversight of the Treasury Department and Federal Reserve pandemic response, on Tuesday in Washington.

House members unanimously passed an extension of the $660 billion Paycheck Protection Program, aimed at helping small businesses weather the COVID-19 pandemic. The voice vote came a day after the Senate approved the measure.

The PPP had expired Tuesday at midnight. If President Trump signs the extension, the program will operate through Aug. 8.

The program was created as part of the original $3 trillion package of economic pandemic relief measures that passed Congress in March. The forgivable loans, doled out by the Small Business Administration, are meant to help small businesses keep employees on the payroll despite lockdowns and a general downturn in business as a result of the coronavirus.

There was a scramble to claim the first round, amounting to $349 billion, which was exhausted in just 13 days. A second round of $310 billion has not been fully spent.

On Tuesday, Treasury Secretary Steven Mnuchin suggested the remaining $140 billion in loans under the program could be repurposed to aid restaurants, hotels and other industries hit hardest by the pandemic.

The extension passed by Congress is aimed at keeping the spigot open while lawmakers mull reworking the program.

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House Follows Senate In Passing Extension Of COVID-19 Business Loans - NPR