As COVID-19 cases continue to spike in Massachusetts, there's another troubling sign that things may continue to get worse before they get any better.
Traces of COVID-19 at the sewage plant that treats wastewater for Boston and many of its suburbs are higher right now than at any point during the pandemic, according to public data shared by the Massachusetts Water Resources Authority.
Dr. Ashish Jha, dean of Brown University's School of Public Health, expressed his concerns about the data over the weekend on Twitter, noting that the state's wastewater data "shows more infections in the community than we had in April."
Others have also been sounding the alarm on social media.
Biobot is testing the wastewater at the Massachusetts Water Resources Authority's Deer Island wastewater treatment plant. The company, the first in the United States to try this approach, has shown it can give an early indication of a rise in cases based just on what's in sewage.
Forty-three communities from eastern Massachusetts have their water treated at the plant, including Boston, Cambridge, Framingham and Quincy.
The data extracted from Deer Island cannot be linked to specific cities, towns or neighborhoods, but it is providing public health officials with a big-picture outlook of what is going on in the region.
Unlike coronavirus cases -- which are detected when people get tested -- COVID-19 data from sewage measures how prevalent the virus is in the community at large, including among people who don't have symptoms and don't get tested, since the virus they shed through body waste would contribute to levels found in sewage.
The wastewater spike comes amid a spike on coronavirus cases, which caused Gov. Charlie Baker to implement new restrictions effective Sunday, including a rollback to Phase 3, Step 1 of reopening, strengthened mask guidance and a reduction in gathering sizes.
For business owners like Erin Madore, Gov. Charlie Baker's announcement has come at a bad time.
Massachusetts health officials reported 3,627 new confirmed coronavirus cases Tuesday. The state Department of Public Health also announced 40 more deaths from COVID-19.
There have now been 10,833 confirmed deaths and 253,649 cases, according to the DPH. Another 243 deaths are considered probably linked to COVID-19 at this time.
The average rate of COVID-19 tests was 5.81% as of Tuesday, according to the report an increase from Monday's 5.46%.
During the virtual meeting, which was broadcast live on the board's YouTube page, District Director Russ Duke said he was contacted by Mayor Lauren McLean asking them to stop the meeting due to an "intense level of protesters in the parking lot and the concern for police safety and staff safety, as well as the protesters that are at some of our board members' homes right now."
Christine Myron, a spokeswoman for Central District Health, told CNN that the board was set to discuss a districtwide public health order about Covid-19 restrictions across its four counties -- Ada, Boise, Elmore and Valley -- that they have been discussing for a number of weeks.
A motion was made about 12 minutes into the meeting to end the session.
As a motion to end the meeting was being discussed, board member Megan Blanksma told other people on the board that she checked with Boise police at the building who told her the situation was under control.
Scores of people, some carrying signs against mandates or lockdowns, were gathered outside the building.
Board member Dr. Ted Epperly responded saying, "Sadly it's not under control at my house, and it's not under control at (board member) Diana (Lachiondo)'s house."
She gave an update on Twitter, writing: "Update: We are fine. Thanks all for your concern and especially @BoisePD for your help."
Boise police said there were protesters at three homes but didn't identify them.
During a meeting Friday, the board presented a draft of a new public health order, which garnered 2,000 written comments before the session and 3,000 after the revisions.
Tuesday's meeting ended before that could be discussed.
Myron said there was increased police presence at their headquarters because they were anticipating significant protests similar to what they saw Friday.
"A large contingent of the population is not in favor of this and definitely wants to express their side of things. So, going forward, we will definitely be having conversations with law enforcement and probably looking to them for guidance on next best steps on how we can have these important conversations in a safe environment, and make decisions that are in the best interest of the communities that we serve," Myron told CNN.
Boise police said there were several incidents that concerned them.
Police intend to charge some people with disturbing the peace at the homes of board members, the release says.
One person was arrested at the CDH building and is accused of trespassing.
The mayor said she consulted with police when she thought things were unsafe.
"My priority was and always will be the safety of our residents; the safety of our children home alone with protesters outside their door; of our residents charged with making public health decisions; of the staff that work at these agencies; and of our officers who put themselves between a mob of people and those tasked with protecting public health," she said in a statement.
She blamed people "outside our community" for stirring up trouble.
CNN has reached out to Boise police and the mayor's office for additional comments.
A new date for the meeting was not announced.
PROVIDENCE, R.I. (WPRI) The number of COVID-19 patients hospitalized in Rhode Island continues to climb.
The state has reached a new all-time high of 461 hospitalizations, according to data released Wednesday by the R.I. Department of Health.
Of those patients, 42 are currently in intensive care and 24 are on ventilators.
State officials have called on anyone with a health care background to help with staffing shortages at the hospitals and field hospitals.
The Health Department also reported 14 additional COVID-19-related deaths on Wednesday, along with 1,232 new infections and a daily positivity rate of 7.6%.
Rhode Island has seen more COVID-19 deaths through the first eight days of December than all of August and September combined
March: 11April: 353May: 463June: 149July: 49Aug: 51Sept: 47Oct: 87Nov: 175Dec: 99 (so far)
Interactive version > https://t.co/p52MWxOdMB pic.twitter.com/032C1tlsE2
Gov. Gina Raimondos next briefing is scheduled for 1 p.m. Thursday. Shes expected to announce whether shell extend the statewide pause beyond Sunday, Dec. 13.
During an interview with 12 News on Tuesday, Raimondo indicated she may have no choice, given the continued surge in new cases and hospitalizations.
Rhode Island health and vaccination officials held a virtual briefing on Wednesday to lay out how the COVID-19 vaccine will be distributed once it receives FDA approval.
Earlier in the day, Canadas health regulator approved the vaccine developed by Pfizer.
Senate Majority Leader Mitch McConnell on Tuesday backed off his demand for businesses to get coronavirus-related liability protections as part of a year-end rescue package.
The Kentucky Republican urged Congress to pass an aid bill that contains neither legal immunity nor state and local government support, two roadblocks to lawmakers striking a relief deal.
"What I recommend is we set aside liability and set aside state and local, and pass those things that we can agree on knowing full well we'll be back at this after the 1st of the year" during the transition to President-elect Joe Biden's administration, McConnell told reporters on Tuesday.
Democratic leaders, who oppose a liability shield, quickly rejected the tradeoff. Senate Minority Leader Chuck Schumer, D-N.Y., told reporters a lack of state and local relief puts teacher and first responder jobs "in jeopardy" in cash-crunched areas of the country. He contended his GOP counterpart is "sabotaging" a bipartisan group negotiating a $908 billion aid proposal.
House Speaker Nancy Pelosi, D-Calif., said in a statement that "the bipartisan negotiations involving Senators and Members of the House have made good progress and must be allowed to proceed without Leader McConnell's obstruction."
In proposing to abandon both contentious issues, McConnell specifically mentioned a handful of areas where Republicans and Democrats have found consensus: Paycheck Protection Program small business loans, money for Covid-19 vaccine distribution and aid for health-care providers, among "a variety of other things that are not controversial." He did not say where he currently stands on direct payments to Americans.
Congressional Democrats, some Republicans and the Trump administration back another stimulus check after the federal government sent $1,200 payments to most Americans earlier this year. Several Senate progressives and one GOP lawmaker have signaled they oppose a relief bill if it lacks a stimulus check.
If Congress resolves neither the liability protection or state and local aid issues this year, McConnell could try to use them as leverage in talks with the Biden administration. The incoming president has backed state and local relief.
Leaders in Washington hope to pass a rescue package before the end of the year after months of inaction. Failure to send more help before then could cut off unemployment benefits to about 12 million people and leave millions facing the threat of eviction.
To strike a deal in time, Republicans and Democrats still need to resolve major disputes over how best to buoy the economy and health-care system. Lawmakers plan to buy themselves more time to reach both pandemic aid and spending agreements by approving a one-week continuing resolution to keep the government funded through Dec. 18.
Officials have put forward a bevy of proposals during the rush to approve aid. Treasury Secretary Steven Mnuchin added one more to the mix on Tuesday: a $916 billion offer made to Pelosi during a phone call.
He said it includes "money for state and local governments and robust liability protections for businesses, schools and universities." Mnuchin added that he and White House chief of staff Mark Meadows reviewed the plan with President Donald Trump, McConnell and House Minority Leader Kevin McCarthy, R-Calif.
The Treasury secretary did not detail what else it includes. In a joint statement Tuesday night, Pelosi and Schumer said McConnell's decision to sign off on a $916 billion package represented "progress."
However, they said "the bipartisan talks [in Congress] are the best hope for a bipartisan solution." They called it "unacceptable" that the Trump administration would put $40 billion toward unemployment payments, less than a fourth of the $180 billion set out by the lawmakers engaged in talks.
The bipartisan group has worked for days to craft a compromise bill. The lawmakers aim to release more details about the proposal this week.
Democrats have embraced the plan as a foundation for talks with Republican leaders. Before Mnuchin put forward the latest White House proposal, McConnell had called for a roughly $500 billion "targeted" bill.
A daily average Covid-19 infection rate of more than 200,000 has overwhelmed hospitals across the country. States and cities have implemented new economic restrictions to slow cases in an already sluggish economy where roughly 20 million people are receiving unemployment benefits.
Congressional leaders have signaled they want to attach coronavirus relief measures to spending legislation. The move would allow Congress to approve both must-pass bills in one swoop.
Reaching agreement on both fronts is the hard part.
The bipartisan plan as first outlined last week would put nearly $300 billion into Paycheck Protection Program small business loans and $160 billion into support for state and local governments that may have to lay off workers. It would reinstate the federal unemployment insurance supplement at $300 per week and put funds into Covid-19 vaccine distribution, education and transportation, among other measures.
The proposal as initially unveiled would also give companies temporary federal liability from coronavirus-related lawsuits until states make their own laws. However, the negotiators have not resolved how to craft final text around legal protections and state and local aid, Democratic Sen. Joe Manchin of West Virginia said Tuesday.
Before Tuesday, McConnell had insisted on including a liability shield in a relief package. His most recent proposal included that provision, along with PPP loans and money for vaccine distribution and education. He has opposed new state and local relief.
Speaking on the Senate floor Tuesday, Schumer urged the GOP to abandon the push for legal immunity.
"The situation is really quite simple," he said. "There are glaring needs across the country, and we will need to work across party lines to pass legislation to meet those needs."
Stimulus checks have emerged as a make-or-break issue in a relief deal. Two senators independent Bernie Sanders of Vermont and Republican Josh Hawley of Missouri have signaled they oppose a package that does not include direct payments to families.
In a letter to colleagues Tuesday, Sanders and five Democratic senators said the bipartisan proposal "does not go anywhere near far enough," according to NBC News. The group, which includes Sens. Elizabeth Warren, D-Mass., Ron Wyden, D-Ore., Jeff Merkley, D-Ore., Ed Markey, D-Mass., and Kirsten Gillibrand, D-N.Y., pushed for direct payments and against legal immunity.
Pelosi told Bloomberg on Tuesday that she still wants stimulus checks in an agreement. She said the question of including them "is really up to the president," according to the news outlet.
On Tuesday, Politico reported that the Trump administration will push for direct payments in aid legislation. At the same time, McConnell's opposition to the provision is "softening," according to the report.
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After weeks of pressure from public health and elected officials, Governor Charlie Baker has announced that Massachusetts is putting new restrictions into place to slow the spread of the coronavirus. The restrictions come as the city of Framingham continues to see a rapid rise in coronavirus cases, which has prompted Framingham Public Schools to go fully remote starting on Monday. GBH Morning Edition host Joe Mathieu spoke with Framingham Mayor Yvonne Spicer about the latest state rollbacks and how she's encouraging residents to slow the spread of the virus in the community. The transcript below has been edited for clarity.
Joe Mathieu: So you've said that each city cannot do this alone, and based on the caseloads that we're seeing, that rings true. Are you encouraged by this latest move by the governor?
Mayor Yvonne Spicer: I'm encouraged, but I also say we need to evaluate it and look to see is there more that we can be doing? Can we identify particular clusters? And so I'm encouraged by the move, but it may not be enough.
Mathieu: But you have said it's not just about rolling back reopening plans, that we need to get creative and we could use some creative solutions right now. Have you been talking about new ideas in Framingham?
Spicer: Well, here in Framingham, not only are we doing more testing, we're contact tracing, the messaging is constant with our residents about wearing face covering, hand washing, social distancing and also limiting gatherings. If people don't live in your households, don't be gathering with them. Those are the messages that we're consistently putting out, and we're just hoping people will take heed to them.
Mathieu: Well, let's get to that because we keep hearing that a lot of the spread is, in fact, coming from small gatherings, house parties, of course, Thanksgiving, and now we're walking up on another set of holidays imminently. How do you get to that? This isn't restaurants and theaters we're talking about.
Spicer: You have to get to a place where people really value each other. It's really about being respectful of each other, and that's some of the messaging I've been sharing with my community. We may not be able to gather for Thanksgiving or other holidays like we normally would, but next year, if we're doing the right thing, we probably will be able to gather. And I need everybody to cooperate. We need everyone in this working together.
Watch: Mayor Spicer on the $18,000 in fines administered by the city for those found violating social gathering restrictions
Mathieu: Well, Mayor, you're in charge of one of the biggest cities in the state in New England, for that matter and I know you just opened another Stop the Spread testing site in Framingham. Is that helping to ease the difficulty of getting a test? Some of these lines have been epic lately.
Spicer: Yes. That is one of our hopes [for] the new site, which opened on Monday. They're ramping up and gearing up, and the goal is to eventually do roughly about 1,000 tests per day by appointment only. So we're grateful to have that site. And for the rest of this week, we have the other two sites and we're still working out how those will continue or will we just end up with the appointment-only site. But that's a work in progress.
Mathieu: I'd like to ask you about schools, Mayor. I know Monday your schools move to a full remote schedule it was one of our top stories with a goal of returning to expanded in-person learning by the middle of January. How many students were getting into classrooms before this was put in place, and what are the metrics you'll use to go back?
Spicer: I have to give our superintendent and the entire school committee credit for really working hard to create a phasing process that is in collaboration with our teachers and our teachers union. And we've been testing it, and it's been tested by having a community infection rate coming into the school, we have a small number of students in the schools. Also our community data; we are evaluating that [and] working very closely with the health department. And based on this surge that we're going through right now, the superintendent made the decision to roll back to remote learning, which I think was a smart move in order to maintain safety of our students, our staff, our teachers and really keep an eye on what is happening in the community in terms of modulating coronavirus in the community.
Mathieu: Mayor, I'd love to ask you about about Christmas and Hanukkah, New Year's, the holidays that are all coming up. What do you tell people when they say they want to be with their families? They want to see their mom and dad, their aunts and uncles. We just went through this with Thanksgiving, and I feel like we aren't talking about this enough as we head into these year-end holidays.
Spicer: The holidays are my favorite time of the year. It's about family, it's about reaffirming those connections with your family, and your community and friends. And this year, I'm asking people to do things differently. Have a video conference with your family members. But if folks don't live in your home, you shouldn't be gathering with them. And I know that's really, really hard for a lot of families, but I think if we're doing the preventive things now, next year we'll be able to all gather together and everybody will be at the table. So it's really about being respectful and keeping everyone safe.
Mathieu: Can I at least drop gifts off on the front step at Mom's house? Is that possible?
Spicer: Oh, most definitely.
Mathieu: I'm trying to figure out how to do this, Mayor. I don't know. It's very kind of you to join us. I know these are confusing times, but also hopeful times as we look down the road a couple of months, Mayor, and consider a very different world when we're all rolling up our sleeves for a vaccine.
Spicer: Absolutely. I'm extremely hopeful that we will get through this pandemic. I'm also optimistic about the vaccine. But once again, keeping an eye on the data, the science of the vaccine, and really looking to see how do we encourage people to, when available, take the vaccine. But even with that, we need to keep a keen eye on maintaining cautious behavior, wearing face coverings, washing hands and socially distance. The vaccine is a part of the process, but not the only thing.
Health care workers at United Memorial Medical Center in Houston face another full-throttle workday last week. Mark Felix/AFP via Getty Images hide caption
Health care workers at United Memorial Medical Center in Houston face another full-throttle workday last week.
The federal government on Monday released detailed hospital-level data showing the toll COVID-19 is taking on health care facilities, including how many inpatient and ICU beds are available on a weekly basis.
Using an analysis from the University of Minnesota's COVID-19 Hospitalization Tracking Project, NPR has created a tool that allows you to see how your local hospital and your county overall are faring. (Jump to look-up tool.)
It focuses on one important metric how many beds are filled with COVID-19 patients and shows this for each hospital and on average for each county.
The ratio of COVID-19 hospitalizations to total beds gives a picture of how much strain a hospital is under. Though there's not a clear threshold, it's concerning when that rate rises above 10%, hospital capacity experts told NPR.
Anything above 20% represents "extreme stress" for the hospital, according to a framework developed by the Institute for Health Metrics and Evaluation at the University of Washington.
If that figure gets to near 50% or above, the stress on staff is immense. "It means the hospital is overloaded. It means other services in that hospital are being delayed. The hospital becomes a nightmare," IHME's Ali Mokdad told NPR.
The University of Minnesota's analysis shows that there are 55 counties where the hospital average has reached that rate.
Use the look-up tool below the map to find details about hospitals in your county.
Thomas Wilburn contributed to this report.
ALPINE, Texas It is one of the fastest-growing coronavirus hot spots in the nation, but there are no long lines of cars piled up for drive-through testing and no rush of appointments to get swabbed at CVS.
Thats because in the rugged, rural expanse of far West Texas, there is no county health department to conduct daily testing, and no CVS store for more than 100 miles. A handful of clinics offer testing to those who are able to make an appointment.
Out past the seesawing oil pumpjacks of Midland and Odessa, where roadrunners flit across two-lane roads and desert shrubs freckle the long, beige horizon, the Big Bend region of Texas is one of the most remote parts of the mainland United States and one of the least equipped to handle an infectious disease outbreak. There is just one hospital for 12,000 square miles and no heart or lung specialists to treat serious cases of Covid-19.
But in a sign that the virus is surging nearly everywhere, the counties that include Big Bend ranked among the top 20 in the nation last week for the most new cases per capita.
Big Bend, best known for its sprawling national park and the artist town of Marfa, offers an extreme example of the danger playing out across the country, as the virus blazes more widely and furiously than ever before, driving deaths to levels not seen since the spring and thrusting many places into crisis at the same time. From California to Texas to Mississippi, hospitals are filling up and health officials in rural communities increasingly fear that they are on their own.
There is no neurologist, there is no long-term care specialist, said Dr. J.P. Schwartz, the health authority in Big Bends Presidio County and a physician at a local clinic. We have no care to help them whatsoever. There is not even a nursing home out here.
Even as hospitalizations and deaths in Texas near their summer peaks, local officials fear they have little power to intervene beyond the measures that Gov. Greg Abbott, a Republican, has put in place.
My hands are tied, said Eleazar R. Cano, the judge in Brewster County, who said he had been advised against imposing a stay-at-home order or other stricter measures that could violate the governors order. Mr. Cano, a Democrat, compared governing through the pandemic to driving his truck through the desert on an empty gas tank, with no cellphone service to call for help.
Its helpless, frustrating, close to panic mode, he said.
Driving the long miles between Big Bends sparsely populated towns, it is hard to fathom how a virus that thrives on human contact could flare in a place with so much wide-open space. Hawks reign in the big blue skies. Cellphone service is spotty. Christmas decorations along the road are not on peoples homes, but on their ranch gates.
Yet somehow, new cases have exploded in recent weeks.
In Brewster County, a sprawling behemoth with 9,200 people spread across 6,000 square miles, more than half of the 700-plus known cases have been identified in the last month. In neighboring Presidio County, with 6,700 people near the border with Mexico, cases have quadrupled in the last two months, from less than 100 to more than 470. Both communities skew older, with people 65 and older making up about a quarter of the population.
The numbers are going straight up at this point, said Malynda Richardson, the emergency medical services director for the city of Presidio, who coughed sporadically as she herself recovered from the icy chills and knockout fatigue of Covid-19.
There are a number of reasons for the spike.
The area is so remote that local residents have to travel to El Paso or Odessa for doctors appointments and to buy necessities at Walmart. With cases soaring across West Texas, the virus may have traveled back with them. Officials also cited everyday movement to and from Mexico, cases among young people at Sul Ross State University and a surge of tourists undeterred by the pandemic.
Visitation was up 20 percent at Big Bend National Park in October, park officials said, and on Thanksgiving weekend so many cars clogged the park it caused a traffic jam. In the liberal artist outpost of Marfa, young people from Austin and Dallas roam the town, sipping almond milk lattes and photographing murals that ask existential questions like, Is austerity an illusion? A recent art installation caused a stir with a blatant message against tourism during the pandemic: Everyone here hates you.
But tourism, it turns out, is not the biggest part of the problem.
The areas limited contact tracing shows more localized spread in bars, in multigenerational homes and through people who ignore positive test results and continue to work and socialize as normal.
In Alpine, the largest city, with a population of 5,900, residents wear masks with their cowboy hats to shop at Porters grocery store, but take them off to eat indoors at restaurants in town. There is far from universal agreement about whether masks are necessary and effective. In a sign of the dispute that has played out on and off social media, the county was left without a local health authority when the doctor in the position, a pediatrician working on a volunteer basis, quit this fall after facing pushback from residents who opposed mask orders and other restrictions.
Brewster County, which includes Alpine, has already instructed bars to close and reduced indoor dining at restaurants from 75 percent capacity to 50 percent, as required by the governors order for counties with a high proportion of Covid-19 hospitalizations. But enforcement is spotty, and the governor has barred local officials from imposing rules that are stricter than his own.
With resources scarce, local health clinics are a primary option for testing, but even then, the swabs have to be driven three hours to El Paso and flown for processing in Arlington, outside Dallas. The National Guard also offers periodic testing, and in response to the growing crisis, new mobile testing vans were scheduled to arrive this week.
For those who do get seriously sick, the hospital, Big Bend Regional Medical Center in Alpine, has just 25 beds and a makeshift Covid-19 ward where patients have been sequestered at the end of the lone, L-shaped hallway.
Dr. John Ray, a family practitioner who works shifts at the hospital, said the hospital on one recent day got back-to-back calls about incoming coronavirus patients. One of them had to be transferred to a bigger hospital in Odessa to receive specialized care.
Not long afterward, Dr. Ray said, he saw the patients obituary in the paper.
I dont want to see Alpine like the pictures you see in New York, just people dying in hallways waiting for a bed, said Dr. Ray, 44, who grew up in the small East Texas town of Troup, moved to Wisconsin for his residency and returned to Texas afterward, settling in the Big Bend region in 2013 for the beauty and the people. He and his wife, also a doctor, usually treat a caseload of strep throat, urinary tract infections and pregnancy visits. Now, he said, its Covid, Covid, Covid.
Across West Texas, higher-level care hospitals are also full. El Paso, which was recently so overrun with infection that it brought in mobile morgues, is still recovering from its own virus surge. In Lubbock, as many as 50 percent of beds were recently filled with Covid-19 patients, and on a particularly bad day last week, the city reported that it had run out of hospital capacity altogether.
Dr. Ray fears there may come a day when more seriously ill patients who would normally be transferred elsewhere will run out of options. To put it bluntly, he said, if you cant go somewhere else, you are going to die here.
A spokeswoman for the Big Bend Regional Medical Center said that the hospital has had enough room so far, and has added ventilators, oxygen tanks and nurses to prepare for a surge. Of nine patients in the hospital on Wednesday, four had Covid-19.
Still, many remain worried. Simone Rubi, 46, a graphic designer and musician who owns a coffee shop in Marfa, about a 30-minute drive from the hospital in Alpine, hung a poster outside her to-go window summing up the precarious situation in four words: Small town, no hospital.
There will be no place for us to go if we get sick thats the bottom line, she said, sitting on a picnic bench outside her shop on a recent Saturday morning.
Wed have to drive to Dallas, said her husband, Rob Gungor, who said he had asthma and had resigned himself to making the nearly eight-hour drive to stay at an Airbnb close to a major hospital if he contracted the virus, to be nearby in case he took a turn for the worse. Like most people in Marfa, which has accepted masks more readily than some other Big Bend towns, he wore a mask even while outdoors.
Maybe Phoenix, he added, because its only a nine-hour drive.
For those who live in even more rural parts of West Texas, navigating the coronavirus spike has come with consequences far beyond the virus itself.
In the border community of Terlingua, there is just one full-service ambulance for 3,000 square miles. Paramedics have on a few occasions had to drive coronavirus patients three hours round-trip to the hospital in Alpine, leaving the region uncovered for other serious emergencies.
That has always been our draw its an isolated, beautiful, unadulterated landscape, said Sara Allen Colando, the county commissioner in Terlingua. But with cases rising, the wilderness is also its own kind of peril.
If they have to take someone with Covid to God knows where, how long is it before that ambulance is back in service? she said. Who is going to be there to answer the call?
Mitch Smith contributed reporting from Chicago.
Raju: Right now, we're in a state of uncertainty. It's clear both sides recognize something NEEDS to happen before lawmakers head back for the holidays and wrap up the work of the 116th Congress. But it's still uncertain what negotiators will agree to, whether the leaders on both sides of the aisle will sign off on it, and perhaps the biggest question of them all: Whether President Donald Trump will sign it.
That means there's a ton of work to do to reach an agreement, get buy-in from all sides and get this to the President's desk before the new deadline: December 18.
Cillizza: Which plan has a better chance of actually passing: The bipartisan $908 billion one or the new $916 billion one from the White House?
Raju: It's going to be a combination of both -- with input from the leadership and the White House. And both plans are light on details. The focus is on the bipartisan plan at the moment, but at some point, the leadership will have to step in and it will have to be a negotiated settlement between the White House and the so-called four corners of Congress: Pelosi, Schumer, McConnell and House Minority Leader Kevin McCarthy.
Cillizza: What's the timeline for getting something done? End of next week? Later? Sooner?
Raju: Next week is the drop-dead date at this point.
Congress is going to pass a one-week stop-gap resolution to extend the government funding deadline until December 18. They want to attach Covid-19 relief to a massive, omnibus spending bill to keep the government open until October 1, 2021.
But that omnibus bill has its own problems, too -- the two sides are at odds on thorny issues that they are trying to resolve. Really, if they want to meet the December 18 deadline, they need to have the outlines of a deal that the Hill leadership and the White House have agreed to by the end of this week because it will take several days to finalize bill language, then they will need to ram it through Congress in just a few days. But doing so will require cooperation from all members in the Senate since any senator can slow down legislation, and that is always a possibility.
Cillizza: Who matters most right now? McConnell? Manchin? Someone else?
Raju: McConnell and Pelosi are the most important players. Even when McConnell isn't directly involved in the talks, his buy-in is essential to getting a deal done. And Pelosi needs to sell her caucus to accept a deal that is far smaller in size and scope than what she has been demanding for months. Typically, there's a center of the universe in negotiations -- Pelosi and Mnuchin for example in recent talks; at the moment, it's this bipartisan group. But that will shift eventually to the leadership.
Cillizza: Finish this sentence: "When Congress leaves for the holidays, the most likely thing they have passed on Covid relief is __________." Now, explain.
Raju: "When Congress leaves for the holidays, the most likely thing they have passed on Covid relief is vaccine distribution."
Even with so much needed right now, from small business loans to extending expiring jobless benefits, vaccine distribution is the one that is least controversial and most urgent. Neither side wants to be blamed for not providing the resources to ensure the American public is vaccinated from Covid-19. The bipartisan group proposes $3.4 billion for grants for states and localities and another $2.6 billion for vaccine distribution and infrastructure. We'll see how much they ultimately agree to include in the spending package.
Gerson, a 45-year-old from Manhattan, arrived at NYU Langone Tisch Hospital on March 18 with shortness of breath, an uncontrollable cough, and a 103-degree fever. A day later, he was diagnosed with Covid-19 and put on a ventilator.
"I just feel tremendously grateful and lucky," Gerson told CNN this week. "The story, if there is one, is not necessarily that I survived, but that these people saved my life. I really felt the need to find them, get their names, and thank them."
He penned a letter in November to thank the doctors, nurses, respiratory therapists and others. Gerson emailed it to a hospital administrator, who passed it along to the staff.
"If you are receiving this letter, it is because I have become aware that you had a part in saving my life," Gerson wrote. "It is only after much effort on my part to find your names that I would realize just how many of you there were on my care team."
It took months to find all the healthcare workers
He sleuthed for the names in three ways. He started with the MyChart app, which tracks a patient's tests and care. Gerson saw who ordered the more than 750 tests, from blood work to EKGs, he underwent while at the hospital.
A nurse helped him get 60 names in a spreadsheet a month after he was discharged in late April. And he scoured insurance reports to see names tied to his insurance claims.
He had to find a way to thank them, he said. Saying thank you when he awoke from the coma was difficult, as the hospital limited the number of staff coming in and out of his ICU room.
"Except for the nurses that I was directly interacting with, there really wasn't an opportunity to say thank you to anybody. It left a void in my emotional recovery," Gerson said. "Here I am having survived, I'm crying with joy every morning and I feel a huge debt of gratitude to these people who I can't even talk to because they're not coming into my room."
A kind nurse excitedly welcomed him back and quickly offered to help him call friends and family who were so concerned about him. No one had been allowed to visit.
Gerson awoke on April 17. "I woke up just in time to call my son on his sixth birthday," he said.
A week later, an "emotional parade through the hallway of the hospital" greeted him when he was discharged, he said.
"It was really a party and a celebration for the people in the hospital," Gerson said. "They were just ecstatic and so happy to be sending someone to rehab alive and with a good prognosis."
The finance professional said he wanted to throw a huge party for everyone who helped him. That was until he realized the world had changed in the time he was sedated.
"I looked out the window and this is when it slowly started occurring to me: The world was not the same world that I left when I went to sleep," he said.
Doctors tried everything they could
The medical team caring for Gerson kept the otherwise healthy, then 44-year-old alive with two types of mechanical intervention.
"Soon after he was admitted to our hospital, he developed respiratory failure and pneumonia with Covid," Angel told CNN. "It was clear that we weren't able to support him initially with the oxygen and then with the mechanical ventilation. Then it became important for him to use the system that is called the ECMO."
"He was very, very sick and we had to keep him under really deep sedation in a way that he couldn't remember anything for at least two or three weeks until his lungs started recuperating with time," Angel said.
Using ECMO and tracheostomies, which were both done for Gerson, were two "controversial" treatments at that point, Angel said. The thought was that these patients were so sick that they would not survive the treatment.
"Jeff was one of almost 50 patients that we placed on ECMO here at NYU during the pandemic," he said.
If not for the ECMO and tracheostomy, Angel said Gerson would have died.
When Angel saw the letter Gerson wrote to those who cared for him, he said it felt "nice" but that the team was just doing their job.
"In the end, we are not looking for anyone to particularly say thank you or anything like that," Angel said.
After working long shifts and not taking time off for weeks and weeks, Angel said that the letter was meaningful.
"You see the significant amount of work that he did and somebody that very likely was going to die in the hospital, makes a full recovery and then he's able to say thank you is very meaningful for us," Angel said.
He couldn't reach one doctor
Gerson was unable to reach one person: Dr. Sydney Mehl, who was treating patients with Covid-19 when he too fell ill and died of the virus, a hospital spokeswoman confirmed.
Mehl, a cardiologist, tested positive for Covid-19 and was admitted to the hospital on March 20.
While Gerson was reading through the last of his insurance claims, he got to the earliest. The doctor on it was S. Mehl, he said.
"It occurs to me that this doctor who gave his life fighting Covid, that I was one of the last patients, if not the last patient he treated," Gerson said.
Since Gerson sent the letter to hospital workers, he said he's heard from even more people who helped care from him.
The number is up to 151.
"Continue doing what you do," Gerson wrote in the letter. "Continue being the heroes you are and know you will forever have my gratitude."
On 6 October, people in a clinical trial of an experimental COVID-19 vaccine waited to receive one of its two doses at Abu Dhabi National Exhibition Centre in United Arab Emirates.
By Jon CohenDec. 9, 2020 , 1:35 PM
Sciences COVID-19 reporting is supported by the Pulitzer Center and the Heising-Simons Foundation.
A COVID-19 vaccine made in China has outstanding efficacy data, according to a press release issued today by the United Arab Emirates (UAE), which has been testing the candidate in a study involving 31,000 people. UAE said that based on an interim analysis of data from that trial, it would formally register, or approve, the vaccine for widespread use. This is the fifth COVID-19 vaccine to show signs of working, and this one uses an entirely different technology from the others.
UAEs Ministry of Health and Prevention said the vaccine, which contains a chemically inactivated version of the pandemic coronavirus and is given in two doses, had 86% efficacy against COVID-19 infectiona phrase that puzzled outsiders, as other vaccines have mainly been assessed for their ability to prevent symptoms. The press release further states that the vaccine completely prevented moderate and severe cases of the disease and raised no serious safety concerns.
Yet it offers no details beyond the efficacy claims. China National Biotec Group (CNBG), which makes the vaccine, did not reply to an email fromScience and has not released its own statement. The UAE ministry and a lead investigator of the trial also did not reply to emails.
The interim results for CNBGs vaccine are very positive. I just hope the results are based on rigorous analysis of the clinical trial data, and the number of infections meets the cutoff requirements as shown in the trials conducted by Western vaccinemakers, says Yanzhong Huang, aglobal health specialist at both Seton Hall University and the Council on Foreign Relations.
In contrast to CNBGs inactivated virus candidate, the four other COVID-19 vaccines that have reported efficacy data rely on the surface protein of SARS-CoV-2, the cause of the disease, to trigger immune responses. Those vaccinesnone made in Chinause messenger RNA that codes for the surface protein or stitch the gene for it into putatively harmless adenoviral vectors. Their developers have reported efficacies of 62% to 95% for protection against symptomatic disease. All four vaccines showed remarkable efficacy against severe disease.
If CNBGs vaccine indeed prevented 86% of infections and 100% of symptomatic disease, it would stand out as the best efficacy data yet. But the few details of the trials protocolavailableindicateit primarily aimed to evaluate the vaccines ability to prevent cases of disease, not infection.
CNBG, a division of state-owned Sinopharm, has two, competitive divisions that produce vaccines using inactivated SARS-CoV-2, one based in Beijing and the other in Wuhan, China. The trial in UAE is part of a 45,000-person study that includes participants from Bahrain, Jordan, and Egypt and compares both vaccines against a placebo shot. According to the UAE press release, the efficacy claim and planned approval only refer to the vaccine made by CNBGs Beijing Institute of Biological Products.
UAE began to usethe CNBG vaccines in September outside of the clinical trial under whats known as emergency use authorization for front-line health workers. Some government officials, including the prime minister, received it, too. CNBG efficacy trials are also underway in Peru, Argentina, and Morocco.
Because China has contained SARS-CoV-2 with its aggressive use of traditional public health measures, CNBG and other Chinese COVID-19 vaccinemakershad to go abroadto test the efficacy of their candidates. Sinovac, a Beijing-based company that also has an inactivated SARS-CoV-2 vaccine in efficacy trials in several countries, may report results from its Brazilian arm soon,Science has learned. The independent board that monitors the trial met yesterday in Brazil to review the data.
