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Category Archives: Covid-19

COVID-19 Daily Update 6-30-2020 – 10 AM – West Virginia Department of Health and Human Resources

Posted: July 5, 2020 at 10:50 am

TheWest Virginia Department of Health and Human Resources (DHHR)reports as of 10:00 a.m., on June 30, 2020, there have been 170,497 totalconfirmatory laboratory results receivedfor COVID-19, with 2,888 total cases and 93 deaths.

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

CASES PER COUNTY (Case confirmed by lab test/Probable case):Barbour (15/0), Berkeley (438/18), Boone(21/0), Braxton (3/0), Brooke (8/1), Cabell (119/4), Calhoun (2/0), Clay(10/0), Fayette (66/0), Gilmer (12/0), Grant (15/1), Greenbrier (58/0),Hampshire (41/0), Hancock (19/3), Hardy (42/1), Harrison (61/0), Jackson(143/0), Jefferson (219/5), Kanawha (303/9), Lewis (18/0), Lincoln (8/0), Logan(23/0), Marion (54/3), Marshall (41/1), Mason (17/0), McDowell (6/0), Mercer(38/0), Mineral (54/2), Mingo (16/3), Monongalia (157/14), Monroe (12/1),Morgan (19/1), Nicholas (9/1), Ohio (90/0), Pendleton (12/1), Pleasants (4/1),Pocahontas (23/1), Preston (63/15), Putnam (54/1), Raleigh (52/1), Randolph(155/1), Ritchie (2/0), Roane (11/0), Summers (2/0), Taylor (15/1), Tucker(6/0), Tyler (4/0), Upshur (18/1), Wayne (110/1), Webster (1/0), Wetzel (10/0),Wirt (4/0), Wood (78/8), Wyoming (7/0).

As case surveillance continues at thelocal health department level, it may reveal that those tested in a certaincounty may not be a resident of that county, or even the state as an individualin question may have crossed the state border to be tested.Such is the case of Braxton County in this report.

Please visit thedashboard at http://www.coronavirus.wv.gov for more information.

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Inside Texas Politics: Austin mayor says based on current COVID-19 trajectory, city could run out of hospital beds in 2 weeks – WFAA.com

Posted: at 10:50 am

The Austin mayor said his city is dealing with the same situation Dallas, Houston and San Antonio are facing -- rising COVID-19 cases and hospitalizations.

The positivity rate for COVID-19 cases in Austin is the highest in the country. That means of the number of coronavirus tests given in Austin, more people are testing positive there than anywhere else in the United States.

Austin Mayor Steve Adler says he is considering a 35-day stay-at-home order.

Adler said they have conferred with scientists and modelers to come up with the shortest period of time to slow down COVID-19 and reopen the economy with greater controls.

"Right now the trajectory in Austin would indicate to us that if we don't do something about the trajectory we're on, we could run out of hospital capacity in two weeks," he said. "ICUs potentially before that."

He said they're dealing with a situation similar to what is happening in Houston, Dallas and San Antonio.

Both Bexar, home to San Antonio, and Dallas counties reported more than 1,000 cases on Friday for the first time. Harris County, where Houston is, has reported more than 1,000 cases in a single day more than once.

The 2020 Austin City Limits Festival was canceled due to concerns about the spread of the disease. What will happen to University of Texas football?

"I can't imagine a world without a vaccine, where you put 95,000 people in a stadium," Adler said.

Adler said even a small number of infected people could spread quickly from that crowd and out into the community, when fans go home.

"Frankly I'm not sure how teams get through an entire fall in that kind of proximity and keep everybody safe," he said.

Adler, a Democrat, has served as the mayor of the state capital since January 2015.

Statewide Headlines

Ross Ramsey, with the Texas Tribune, joins Jason Whitely.

1. Lt. Governor Dan Patrick took issue with Dr. Anthony Fauci last week when the doctor said that states like Texas have skipped over reopening guidelines. The lieutenant governor said in an interview that Texas hasnt skipped over anything. Patrick added that Dr. Fauci has "been wrong every time on every issue." The lieutenant governor issued a statement later asking why Fauci had nothing to say about mistakes made in New York and even California. Dr. Fauci is the nation's top infectious-disease specialist. Is there any kind of political strategy in what the lieutenant governor said?

2. Bars are now suing the state after the governor ordered them to close. Gov. Greg Abbott caved with Shelley Luther and her hair salon in Dallas. How might this play out?

Mask wearing will 'increase freedom'

For weeks, U.S. Surgeon General Jerome Adams has supported wearing face masks. But he understands the challenge of getting people to wear one.

Adams had this message for Texans:

"If you want to see the Dallas Cowboys play again in person, if you want to see the Houston Texans play again in person, if we want to get back to some sense of normalcy -- with church, with school, with businesses, then the fastest way to make that happen is by wearing a face covering."

Adams called wearing a mask "a small inconvenience that will actually increase your freedom."

The best way to ensure communities can reopen, said Adams, was to follow these public health precautions.

Adams has three kids, and said he and his family are actively discussing whether their children will go back to school in person.

He said things are changing quickly for COVID, but said, in order for school to take place safely, schools need to be preparing now by considering everything from transportation to distancing to online access.

Second shutdown could be catastrophic for restaurants

The Texas Restaurant Association is concerned that some cities might restrict restaurant operations again as the coronavirus continues its spread.

All of those factors could have dire consequences for restaurants.

Emily Williams, president and CEO of The Texas Restaurant Association, said another shutdown would paralyze the industry.

"With the first shutdown, we're projecting about 30% of our 50,000 restaurants won't make it through," she said.

The TRA estimates 50-75% of restaurants would close if a second shutdown occurred.

The TRA has put together its "Survival Plan," which outlines what the $66 billion industry needs to move forward. It includes tax relief, liability protection, and an assistance fund to help restaurants deal with the demands of COVID-19.

Reporter Roundtable

Featuring Jason, Ross, Bud Kennedy of the Fort-Worth Star-Telegram, and Berna Dean Steptoe, WFAA political producer.

1. Joe Biden had a good week last week. Now the talk is about who he will select for a running mate. The Democratic National convention is about six weeks away. Is there a running mate who would help or hurt him in Texas? Selecting a woman -- any names he might be considering that we havent heard?

2. It's the middle of an exhausting, frustrating year. Some public officials are just beaten down. Should more retirements at all levels be expected after the November elections?

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Inside Texas Politics: Austin mayor says based on current COVID-19 trajectory, city could run out of hospital beds in 2 weeks - WFAA.com

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Local officials kept in the dark by Whitehall on Covid-19 testing data – The Guardian

Posted: at 10:50 am

Local health officials are being kept in the dark about Covid-19 infections in their area by Whitehalls refusal to share all of its data, Andy Burnham, the mayor of Greater Manchester, has warned.

Public health officials and council leaders also told the Observer that they were receiving only partial postcode data, which prevents them from precisely monitoring local areas, and could allow the virus to spread.

Burnham has urged ministers to change their approach after a week that saw Boris Johnson impose a local lockdown on Leicester when health secretary Matt Hancock, revealed that the city had seen a surge of 944 Covid-19 cases over two weeks.

Amid a public row between ministers and Leicesters mayor, Sir Peter Soulsby, health officials finally began sharing more data with the city authorities last Wednesday. Previously, all councils had to wait for official Public Health England data to be published, which meant a two-week lag.

Yet significant problems remain, Burnham told the Observer. We need a new principle going forward: everything the government knows, we should know and at the same time that they know it. Because we cannot contain this virus if people at a local level are being kept in the dark.

Public Health England (PHE) wrote to councils directors of public health last Monday with details of how to access pillar two data that taken from home testing kits and mobile testing sites set up by Deloitte. Until that point, local authorities had only pillar one data how many people in hospitals had tested positive. In Manchester, there had been 78 pillar one cases, but that jumped to 465 when pillar two figures were revealed.

We get pillar two data once a week, on a Monday morning, Burnham said. But a lot can happen in seven days. So if were going to manage and chase this virus down on the ground, we need the same daily data that the government gets.

Its as if the government doesnt trust the professionals working at local level

They also wont provide patient-identifiable data. Our teams tell me that is crucial, but the government cites patient confidentiality. Our teams are experienced public health staff they know how to deal with data confidentially. Its as if the government doesnt trust the professionals working at local level.

Government health sources insist that data protection issues limit who can access postcode-level data, since if the information were to leak beyond councils and the NHS, it could be used to identify individuals.

This week, the government is expected to publish an outbreak framework as guidance on what might trigger further local lockdowns. Ministers are understood not to be following the approach used in Germany, where local lockdowns are considered whenever the number of cases reaches a threshold of 50 per 100,000 people.

A further problem for local health teams is that there is a huge quantity of testing data to decipher, including hospital admissions, contact-tracing data from the NHS system and their own local intelligence.

Louise Jackson, portfolio holder for public health and wellbeing at Bedford Council, said her teams were still not getting good-quality information.

They tell me there are duplicates for example, if there are four results in one postcode area, does that mean youve got four cases, or one person who has been tested four times? They just dont know. The local data dashboards only give the number of tests, not how many were positive or where they are. Its very, very messy.

A senior director of public health, speaking anonymously, said: The government says data is now flowing, but thats just spin. Its not granular enough, its not quick enough and its not frequent enough. What weve been told is that the commercial company operating pillar two didnt set the data up so it can shared easily, and that the quality was poor as well.

MPs have raised questions about the role of Deloitte, which was appointed to run testing centres in March. In a written answer last week, health minister Nadine Dorries admitted that the government contract does not require the company to report positive cases to PHE.Stella Creasy, the MP for Walthamstow who tabled the question, said: This is a mess. Local authorities need clear data about positive tests: where theyve happened, whos involved and who is isolating. And that should be what the government has commissioned. Its becoming very clear thats not the case.

Deenan Pillay, a professor of virology at University College London and a member of the Independent Sage group of scientists, said he was consulted by Deloitte about setting up the testing sites in March.

I told them one of the key things would be data flow, since that is critical to optimal use of the data for individual clinical care and pandemic control, he said.

Health data is a very complex area, and the problems we are seeing are some of the consequences of this being set up as a structure separate from the NHS, rather than being linked to the NHSs laboratory and data systems.He said that testing did not just happen in a lab but was a whole process that began with collecting the right patient information. NHS tests use patients NHS numbers, allowing results to go to their GP, Pillay said.

We are now seeing the consequences of this lack of data integration with primary and secondary care, PHE and local directors of public health, which needs a lot of behind-the-scenes retrofitting.

Whitehall did not respond to questions from the Observer about the sharing of data.

Deloitte said that the consultancy had designed the online form used to book and register tests and had commissioned testing sites, but did not run either them or the testing labs. Test results are sent from labs to the National Pathology Exchange, which connects NHS labs with other parts of the NHS, including NHS Digital.

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Lancaster County bicycle shops face inventory shortage brought by COVID-19 and warmer weather – LancasterOnline

Posted: at 10:50 am

The confluence of warmer weather and the sudden age of quarantine has led to a national surge in bicycle sales.

These days people are buying whatever they can get their hands on, Bob Addams said of his Elizabethown shop, Bicycle Outfitters. Theyre not worried about color and size.

Retail cycling sales in the U.S. increased by 75% in April to more than $1 billion, according to NDP Group. It is the first time the market research company recorded more than $1 billion in industry sales for a single month April sales are usually between $550 million and $575 million.

Its one of the few things left that people can do, Addams said.

But there is a problem: Addams said his shop is virtually empty and it may stay that way for a while.

I dont expect to get more inventory for the sales floor until next year, said Addams, adding bikes from his vendors are backordered to at least December.

Im trying not to complain, he said, noting weve been lucky to remain open during the COVID-19 pandemic, unlike many other businesses that were ordered closed, some which never reopened.

But we wouldve been able to sell all sorts of other bikes and get more, Addams said. My sales were up to this point, but going forward, its going to be horrible.

He said the repair side of his business is through the roof but noted its almost impossible it will entirely make up for lost bike sales.

Addams isnt alone as bike shops across Lancaster County and the nation face a supply problem compounded by the pandemic.

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Like Addams shop, business has been brisk at Lancaster Bike Shop in Manheim Township, where service manager Rusty Gramm said sales in May were nearly double than normal.

But most bicycles are made overseas, including Europe and Asia, and Gramm said he was told several vendors ceased production when the pandemic reached their areas, which has led to a shortage.

The months-long pause in production was compounded by a spike in demand domestically.

Gramm said Lancaster Bike Shop is starting to run scarce on bikes. Fully stocked, he said the shop has anywhere between 150 to 200 bikes. In late June, the shop had 40 bicycles, and dropping.

Its great that there are people wanting to get on bikes, but (the industry doesnt) have the infrastructure to keep this up, said Adriana Atencio, director of development at the Common Wheel.

The Common Wheel, with its bike shop at 324 N. Queen St. and its co-op at 701 E. King St., has no new bikes left priced under $1,000, Atencio said. Bike parts and accessories such as vehicle bike racks have also flown off of shelves.

Its a shortage nationwide, she said, adding that the Lancaster city-based nonprofit has received calls on bike availability from as far as Texas.

Gramm remains optimistic, saying his vendors were eventually able to ramp up production again, and Lancaster Bike Shop is expected to receive additional bikes by late July or early August.

I think were going to catch up (with demand) he said. And were really excited that people are riding bikes.

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On The Brink, Rural Hospitals Brace For New Surge In COVID-19 Cases – NPR

Posted: at 10:50 am

A hallway leads to a makeshift isolation ward for COVID-19 patients. Kirk Siegler/NPR hide caption

A hallway leads to a makeshift isolation ward for COVID-19 patients.

In the Idaho mountain town of Grangeville, population 3,200, signs in windows on Main Street advertise that Border Days "is on."

The annual Fourth of July celebration boasts street dances, Idaho's longest-running rodeo and even the world's largest egg toss. Like in a lot of small towns, Grangeville's economy has been struggling throughout this pandemic.

Border Days planners decided to go ahead with an altered, if slightly scaled back version of the festival this year amid worries about a possible spike in coronavirus cases.

Grangeville's population tends to skew older and underinsured.

"It's going to be a little risky," said Joel Gomez, owner of The Trails Restaurant & Lounge. "I feel like we're going to get hit with the corona after this."

With so many other July Fourth events canceled in the rural Northwest, local business owners such as Gomez are preparing for an onslaught of potentially thousands of tourists descending on the town.

Trails is one of the festival's street dance and live music venues. Gomez is moving everything he can outside, taking reservations and spacing out tables.

Border Days organizers say they're taking similar COVID-19 precautions. There have been only three confirmed cases in Idaho County since March. People around here have been taking the virus seriously, Gomez says, but after two months of shutdowns, his business is barely hanging on.

"It's one of those things that you have to survive," he said. "You've got people out there [trying] to feed their family. We are in the same boat."

Up the street, at the 16-bed Syringa Hospital and Clinic, CEO Abner King says his staff is prepared for a possible surge in coronavirus infections in a couple of weeks.

"It's pretty hard to do an egg toss in a socially distancing manner," he chuckles.

Syringa Hospital's CEO, Abner King, says his staff is ready for a possible surge in COVID-19 patients, as long as larger regional hospitals aren't overwhelmed. Kirk Siegler/NPR hide caption

Syringa Hospital's CEO, Abner King, says his staff is ready for a possible surge in COVID-19 patients, as long as larger regional hospitals aren't overwhelmed.

Syringa doesn't have an intensive care unit or even a ventilator. Most patients in need of critical care are transferred to larger regional hospitals, which so far during the pandemic have not been overwhelmed themselves as first feared.

Syringa staff members have been preparing and instituting precautions for months, yet to date they've not treated a single COVID-19 patient.

"That's the tough part about all this, because you get all ready for this big emergency and then nothing happens and then you have to fight complacency a little bit," King says. "We prepared for a flood, and then we were hit with a drought."

That "drought" has severely affected Syringa's bottom line. The irony is that small-town hospitals like this one are now on the brink of going broke during the pandemic. King says people just stopped coming into the hospital, its clinic and even its emergency room. All elective procedures were canceled. Since the pandemic took hold in March, revenue here has dropped by half.

Across the U.S., rural "critical access" hospitals were already closing at an alarming rate before the pandemic. Twelve have shuttered since the start of this year alone.

"Even without the pandemic, there's not a lot of room for surprises and errors," King said.

One of the main reasons that the hospital has stayed afloat since March is because of federal relief money. Among other things, it has helped pay for personal protective gear and other supplies as well as the construction of a temporary isolation ward for COVID-19 patients.

Past the hospital's small nursing station and down toward the end of a short corridor, there is a makeshift wall of heavy-duty plastic beneath the fluorescent lights. More air-handling units are on back order too, should the hospital need to convert more rooms to negative pressure.

Hospital leaders say a separate chunk of federal relief money, roughly $1.8 million in payroll protection loans, has also been a lifeline for avoiding layoffs.

That money is running out in the next few days, but King says business has recently picked back up to near pre-pandemic levels, as non-COVID-19 patients are starting to return to the clinic and hospital.

This is big, because in small towns like Grangeville, the hospital is often one of the largest employers.

"It's been stressful because it's just the unknown," said Melissa Holman, a nurse at the clinic. "You come to work and you never know if you're going to be exposed, and I have family members that are high risk."

Holman is back at work now after taking a voluntary furlough for 2 1/2 weeks this spring. It has been a struggle. Her husband is a rancher. They have two young kids, one in elementary school and another in day care; both the school and day care closed. A furlough did mean that she and her family could stay on the hospital's insurance.

Holman is watching as coronavirus cases are rising steeply elsewhere in Idaho. Worried about a similar fate for Grangeville, she's not convinced that school will reopen here as planned come fall.

"That could bring another hardship against our family trying to cover child care and homeschooling, along with maintaining a full-time job," Holman said.

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Braves’ Freddie Freeman has COVID-19 and it is ‘going to be a while’ until he can join the team – CBS Sports

Posted: at 10:50 am

When the 60-game regular season begins later this month, the Atlanta Braves may be without star first baseman Freddie Freeman. On Saturday manager Brian Snitker told reporters, including The Athletic's Dave O'Brien, that Freeman has contracted COVID-19 and has a fever, and it is "going to be a while" until he can join the team.

"He's running a fever, he has symptoms. He's not feeling great, as you do when you get this," Snitker said during a conference call with reporters. "But he's young and strong. The biggest thing we want him to do is get right and get better"

Freeman tested negative for COVID-19 on Monday and Tuesday as part of the summer camp intake testing, according to Snitker. He developed symptoms soon thereafter and was tested again, which resulted in the positive test. Summer camp opened Wednesday with each team holding their first official workout either Friday or Saturday.

Snitker confirmed three other Braves also tested positive for COVID-19: Pete Kozma, Touki Toussaintand Will Smith. Toussaint and Smith are asymptomatic, according to Snitker. Kozma has symptoms and is not with the MLB team. He is with the club's satellite player pool at their alternate training site. Snitker did not provide a timetable for their returns.

MLB created a new COVID-19 injured list with no minimum or maximum stay. It can be used not only when a player tests positive, but also when a player shows symptoms or has contact with someone who is confirmed to have COVID-19. A player must meet certain criteria to be activated off the COVID-19 list, including two negative tests at least 24 hours apart.

Because COVID-19 is classified as a "non-work-related" injury, it is subject to the privacy guidelines in the collective bargaining agreement. That means the team can not announce a player has COVID-19 without his permission. Freeman, Kozma, Toussaint, and Smith obviously gave the Braves permission. If not, Snitker would not have been allowed to discuss their absences.

Should Freeman miss the start of the regular season, the Braves could put Austin Riley at first base (he started three games there last season) or carry veteran non-roster invitee Yonder Alonso on the Opening Day roster. Shane Greene or more likely Mark Melancon would be the likely candidates to step in at closer should Smith miss the start of the season.

MLB announced Friday that 3,185 samples were collected during intake testing this past week and 38 came back positive (31 players and seven non-player personnel). The testing results are not complete -- the Athletics and Brewers are still awaiting their final results -- but the 1.2 percent positive rate is promising. The NBA had a positive rate over seven percent, for example.

Braves first base coach Eric Young Sr. has opted out of the 2020 season, Snitker confirmed. Young is a high-risk individual. "It weighed on him quite a bit. We'll miss him dearly," Snitker said.

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Braves' Freddie Freeman has COVID-19 and it is 'going to be a while' until he can join the team - CBS Sports

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NFL sends teams COVID-19 protocols for training camp, including interaction with players who test positive – CBS Sports

Posted: at 10:50 am

Watch Now: NFL Supports Redskins Name Change (8:26)

Training camp is just weeks away, and NFL teams finally have COVID-19 protocols in place as players are preparing to arrive to their team's complex -- where they will be stationed for six weeks until the regular season begins. The good news for the players is that they won't be in a bubble even though there are aggressive guidelines to follow.

Per NFL Network's Tom Pelissero, players have an extensive breakdown for handling situations where they are exposed to someone who tested positive for coronavirus.

Here's a quick breakdown based on what the NFL provided to the teams:

A. Close Contact Exposure to Symptomatic or COVID-19 Positive Individual

1. PCR virus test as soon as possible (and isolation until results available)

a. If virus test is negative and close contact remains asymptomatic

1a. Close contact may return to the facility and subject to the following

b. If virus test is positive and individual has no symptoms

1a. No return unless and until

c. If virus test is positive and individual is symptomatic

1a. No return unless and until

B. Low or Medium Risk Exposure to Symptomatic or COVID-19 Positive Individual

These guidelines are strict and likely confusing for players and team members, but it's a procedure they will have to grow accustomed to in 2020. The teams already have a memo on how workouts and meetings are to be conducted, another adjustment the franchises will have to make later this month.

All of this is shaping up for an interesting summer in the NFL.

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COVID-19 Daily Update 7-2-2020 – 5 PM – West Virginia Department of Health and Human Resources

Posted: July 3, 2020 at 5:45 am

TheWest Virginia Department of Health and Human Resources (DHHR)reports as of 5:00 p.m., on July 2, 2020, there have been 178,238 total confirmatory laboratory results receivedfor COVID-19, with 3,053 total cases and 93 deaths.

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

CASES PER COUNTY (Case confirmed by lab test/Probable case):Barbour(15/0), Berkeley (443/18), Boone (20/0), Braxton (3/0), Brooke (8/1), Cabell(136/6), Calhoun (2/0), Clay (10/0), Fayette (67/0), Gilmer (13/0), Grant(15/1), Greenbrier (60/0), Hampshire (42/0), Hancock (20/3), Hardy (44/1),Harrison (66/0), Jackson (143/0), Jefferson (229/5), Kanawha (324/9), Lewis (19/1),Lincoln (8/0), Logan (25/0), Marion (60/3), Marshall (40/1), Mason (19/0),McDowell (6/0), Mercer (45/0), Mineral (55/2), Mingo (19/3), Monongalia(179/14), Monroe (13/1), Morgan (19/1), Nicholas (11/1), Ohio (99/1), Pendleton(12/1), Pleasants (4/1), Pocahontas (27/1), Preston (67/15), Putnam (59/1),Raleigh (53/1), Randolph (161/1), Ritchie (2/0), Roane (11/0), Summers (2/0),Taylor (15/1), Tucker (6/0), Tyler (4/0), Upshur (20/1), Wayne (114/1), Wetzel(10/0), Wirt (4/0), Wood (94/8), Wyoming (7/0).

As case surveillance continues at thelocal health department level, it may reveal that those tested in a certaincounty may not be a resident of that county, or even the state as an individualin question may have crossed the state border to be tested.Such is the case of Boone, Greenbrier, and Mingo counties in this report.

Please visit thedashboard at http://www.coronavirus.wv.gov for more information.

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One U.K. trial is transforming COVID-19 treatment. Why haven’t others delivered more results? – Science Magazine

Posted: at 5:45 am

A World Health Organizationled global trial of treatments for COVID-19 was slow to enroll coronavirus-infected people, like this one in a Spanish intensive care unit,whereas a large trial in the United Kingdom quickly produced results for threetreatments.

By Kai KupferschmidtJul. 2, 2020 , 5:30 PM

Sciences COVID-19 reporting is supported by the Pulitzer Center.

On 29 June, University of Oxford clinical scientists Martin Landray and Peter Horby changed how physicians around the world consider treating COVID-19for the third time in little more than 3 weeks. The principal investigators of a U.K. megatrial called Recovery, which has been testing existing drugs as therapies for the new infection, the pair had just finished reviewing data from 1596 patients who had received a combination of lopinavir and ritonavir, two antivirals known to curb HIV, and 3376 patients who had received only standard care. In a press release, they and their Recovery colleagues announced there had been no significant difference in the death rate between the two groups. This could have worked. And it was a bust, says Eric Topol, director of the Scripps Research Translational Institute. It was really important to clarify that.

Earlier the same month, and again through press releases, Recovery (Randomised Evaluation of COVID-19 therapy) delivered widely accepted verdicts on two other treatments. It revealed that dexamethasone, a cheap steroid, reduced deaths by one-third in patients on a ventilator and showed that hydroxychloroquine, the antimalarial drug controversially touted for COVID-19, did not benefit hospitalized patients. A run on dexamethasone ensued as physicians in the United Kingdom and elsewhere quickly made it part of their standard of care for the sickest patients, whereas many other studies of hydroxychloroquine now looked futile and were halted.

Its very, very rare that you announce results at lunchtime, and it becomes policy and practice by tea time, and probably starts to save lives by the weekend, Landray told Science at the time of the steroid result.

Large, randomized trials are the gold standard to test a drugs efficacy. But they have been scarce so far in the COVID-19 pandemic. Everybody has the first part about randomized, but they omitted the large part, says Ana-Maria Henao Restrepo, a medical officer at the World Health Organizations (WHOs) Emergencies Programme. Every clinician, every researcher wants to help and then they end up having a trial with 300 or 400 patients that cannot come up with conclusive evidence. In a sea of small, single institution studies, Recovery, with 12,000 patients and hundreds of participating hospitals, stands outand offers lessons for the few other megatrials, organized by WHO and other bodies, which have been slow off the mark. I think the three Recovery trials are the best trials that have been performed to date, Topol says.

One reason Recovery has done so well is that it was backed by the United Kingdoms centralized National Health Service (NHS), involving 176 of its hospitals. In the United States, where the health care system is fragmented, the National Institutes of Health has only begun a few large trials so far and completed just one, a trial of Gilead Sciencess antiviral compound remdesivir that showed those given the drug recovered from COVID-19 faster. The dearth of results from a country that has seen more cases of COVID-19 than any other is surprising and a bit disappointing, says John-Arne Rttingen, who heads the steering committee of Solidarity, WHOs attempt to evaluate repurposed drugs as possible COVID-19 therapies.

In contrast, the United Kingdoms own bungled public health response to the new virus, which has led to Europes largest outbreak, has been taken advantage of by Recovery. They have been able to recruit well, because they have had a lot of hospitalized patients, Rttingen says. (The United Kingdom has had more than 43,000 deaths, surpassed only by the United States and Brazil, far more populous countries.)

In a letter to all NHS hospitals, the United Kingdoms five most senior doctors urged health care workers to enroll patients in Recovery and two other important trials. Use of treatments outside of a trial, where participation was possible, is a wasted opportunity to create information that will benefit others, the doctors, including Chris Whitty, chief medical officer for England, wrote. Because of that coordination, One in every six COVID-19 patients that come into the U.K. hospitals go into the trial, Landray says.

Organizers also kept Recovery simple, allowing any NHS hospital to participate. Inspired by trials that his Oxford colleague Richard Peto and others did in the 1980s on treating heart attacks, Landray says they radically cut down on the data health care workers need to collect, with only a few questions asked at enrolment and at only one more data collection point: when the patient dies, is discharged, or 28 days after enrollment. Clinical trials have become excessively cumbersome in recent years, he argues. Its actually quite hard to make them really simple.

WHOs Solidarity trial has a similarly straightforward design, but its more international nature has proved a challenge. The trial, designed to test four treatmentshydroxychloroquine, lopinavir/ritonavir, interferon beta plus lopinvir/ritonavir, and remdesivirwas announced on 20 March and enrolled its first patient in Norway 1 week later. But rolling out the trial in dozens of countries has meant getting approval from dozens of regulatory agencies and ethics boards as well. That has taken a surprisingly long time in many jurisdictions, including in Europe, Rttingen says, and recruitment in Europe slowed over time as the epidemic subsided. When countries were ready to sort of start, the epidemic was under control in many ways, he notes.

A European trial called Discovery, coordinated by the French research institute INSERM and partnered with Solidarity in testing the same drugs, also fell short. The goal was to enroll 3200 patients across the continent, but although the study almost met its goal of 800 participants in France, it barely managed to recruit patients elsewhere. Though France funded its part of the trial, it expected partner countries to pick up the tab for their own trials. One of the issues was that not all the countries had funding, says Yazdan Yazdanpanah, head of infectious diseases at INSERM.

Meanwhile dozens of small trials competed for patients in many countries, most of them focusing on the same drugs, such as hydroxychloroquine. I dont understand why everyone was looking at the same thing, Yazdanapanah says. I think we can do better. Susanne Herold, an expert on pulmonary infections at the University of Giessen, agrees. There needs to be more coordination both within countries and across borders, she says.

Another problem has been the widespread use of treatments outside of randomized trials. Landray notes that tens of thousands of COVID-19 patients in the United States have been given convalescent plasma, for instance, but not alongside a control population receiving a placebo. We'll know what happened to those patients, but we won't know whether they would have been better off actually, if they hadnt got the convalescent plasma. Partly it is about convincing clinicians that there is still an open question, Henao Restrepo says. I have talked to about 2000 clinicians all over the world in the process of establishing Solidarity, and some of them are convinced they know which drugs work.

Henao Restrepo still has high expectations for the Solidarity trial. The preparatory work is paying off, she says. Its recruitment pace has picked up as more countries have joined, many with surging cases, including Iran and countries in Latin America. So far, 31 countries have joined and 60 more are in the process. One of the advantages of such a global trial is that you can follow the pandemic as it evolves, Rttingen says.

With recruitment running at about 500 patients per week now, Solidaritys three remaining treatment armsit stopped the hydroxychloroquine oneare likely to yield answers soon, raising the question of what drugs to test afterward. Some repurposed drugs such as camostat mesylate or favipiravir are still being discussed, but increasingly the attention is turning to monoclonal antibodies, designed to target the virus.

Henao Restrepo thinks the international nature of the effort makes its results more generalizable. The feeling that all kinds of patients and hospitals participated is an important part of accepting the findings, she says. And the global effort gives the people all over the world, clinicians all over the world the possibility to contribute.

Herold adds that the Discovery trial will also contribute, because it is designed to gather more detailed data than Recovery and Solidarity. Started in an effort to supplement Solidarity, it collects not only basic data on mortality, but also information on viral levels and certain blood parameters. Those data can indicate not just which drugs are effective, but also how they work and at what stage of the disease, Herold says, crucial to informing follow-up research or trials.

Work on the Recovery trial continues, with Landray, Horby, and the rest of their team scrambling to publish full results. Some researchers have criticized its practice of releasing important results as press releases; so far, it has given details for only one of the three headline findings, on dexamethasone, in a preprint posted 6 days after the release. The researchers are also continuing to collect data on the antibiotic azithromycin, an antibody called tocilizumab, and the antibody-rich plasma collected from recovered patients.

Results on those therapies are likely months away, Landray says. But he cautions he has been wrong before. On the morning of 4 June, he had predicted the first results from Recovery would likely come in early July. A few hours later, the chairperson of the trials data monitoring committee called him to say there was enough patient data to declare a verdict on hydroxychloroquine.

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One U.K. trial is transforming COVID-19 treatment. Why haven't others delivered more results? - Science Magazine

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COVID-19 is on the rise again in Ohio, and an expert blames young people who aren’t wearing masks – NBC News

Posted: at 5:45 am

So much for Ohio flattening the coronavirus curve.

Gov. Mike DeWine moved aggressively to slow the spread of the virus by shutting down the economy and issuing stay-at-home orders, but COVID-19 numbers have been climbing again after DeWine started reopening the state.

There have been 9,779 new cases just in the last two weeks, a 73 percent jump over the number for the two weeks before, according to the latest NBC News tally. And on Tuesday, there were 13 more deaths reported and 1,076 new cases.

In total, 2,876 people have died from the coronavirus in Ohio out of 52,865 reported cases since the start of the pandemic, the NBC News figures show.

"People are letting their guard down," DeWine said Thursday. "The progress the state has made is in danger of being reversed."

"We're in a crisis stage in Ohio and this can go one way or the other," the governor added.

Dr. Stephen Blatt, medical director for Infectious Disease at TriHealth Hospitals in Cincinnati, agreed and noted that young people are increasingly the ones getting infected.

I dont think we reopened too soon, our numbers were very good, Blatt told NBC News. The problem is that people are not wearing masks. You go out and everywhere you look theyre not wearing masks.

Ohio is hardly the only state that has seen a big jump in numbers. Arizona, Florida and Texas in particular have reported an explosion of new cases. And nationally, there have been more than 2.7 million reported cases and nearly 130,000 deaths, the latest NBC News figures show.

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DeWine received bipartisan praise for moving decisively to secure his state well before President Donald Trump declared a national emergency on March 13. Both he and Dr. Amy Acton, the states former health director, were lionized for leading the state through the crisis.

While Gov. Tom Wolf in neighboring Pennsylvania has issued a mandate which requires people to don a mask whenever they leave their homes, DeWine said "that's not our intent."

But during a news conference to announce guidelines for reopening Ohio's schools in the fall, DeWine said "Im not ruling out additional orders."

"Remember, we wear masks to protect each other, often because people are sick, but show no symptoms," the governor said. "Masks can be especially useful and are strongly recommended at any grade level during periods of increased risk and when physical distancing is difficult."

While DeWine is a Republican, its not clear a mask-wearing directive would fly in a state where the GOP holds a majority in the legislature and in which conservative lawmakers resisted the governors moves to curb coronavirus by closing down the state.

Ohio State Rep. Tavia Galonski, a Democrat, said she wishes DeWine would try.

Sure, there would be people who would complain, but those same people had an Ohio that we all could be proud of before DeWine turned tail and ran, Galonski told NBC News. I believe Ohioans would have responded quite well to an authoritative figure they could trust telling them to put on a mask.

Blatt said he knows masks will be a hard sell with some in Ohio.

Im sure the governor is wrestling with that, he said. If there was some way to mandating mask use, that would be helpful.

Acton stepped down in June after Ohio Republicans tried to curb her powers and protesters besieged her home demanding an end to the states stay-at-home measures. The governor said Acton would continue serving as his chief health adviser.

Not long after, the number of coronavirus cases began rising again in Ohio.

Asked whether there could be a connection between Actons departure and the increased cases, Blatt said no. She was a calming influence, the doctor said of Acton.

Ohio appeared to be on a different trajectory on May 1 when DeWine began lifting the states stay-at-home rules and a month later the numbers continued to be flat.

"We're not seeing any significant increase or reestablishment of a wave or a peak in Ohio and thats great," Mark Cameron, an infectious disease researcher and professor in the school of medicine at Case Western Reserve University, told the Cincinnati Enquirer in a story published June 16. "What that could mean is that people are still generally following the guidelines."

Thats clearly no longer the case, said Blatt.

Most of the new cases are young people and I think they just got sick of not going out and seeing their friends, Blatt said. I think they saw that things were getting better and just said, OK, lets go out. We have to get the message out that this is not over and its not going to be over for a while.

The drive to get people to wear masks has, of late, been driven by Republicans like the Texas governor who had previously been following the lead of Trump, who has rarely worn one in public.

Trump, in an interview Wednesday, said hes all for masks but does not think they should be mandatory for people in public places. Pence echoed that Thursday, saying "I don't think there's a need for a national mandate."

Florida Sen. Rick Scott, a Republican and a Trump ally, used similar language Thursday in a Fox News interview.

Look, you should wear a mask, you should social distance, Scott said. But should governments mandate these things? No.

But Florida, where Gov. Ron DeSantis has been criticized for responding too slowly to the crisis and for reopening too soon, reported 6,563 new coronavirus cases Wednesday and 145 deaths, according to the NBC News tally.

There have been 76,278 new cases reported in Florida in the last two weeks alone, according to NBC News figures, forcing DeSantis to shut down the bars to slow the spread of the virus.

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COVID-19 is on the rise again in Ohio, and an expert blames young people who aren't wearing masks - NBC News

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