LAWRENCE, KS Back in September, LMH Health announced the funding received through the Coronavirus Aid, Relief and Economic Security (CARES) Act. One major area of focus for LMH Healths funding request was testing in three specific areas: mass community testing, back-to-school baseline testing and healthcare and first responder surveillance testing.
Over the past few months, we have been working in partnership with Lawrence-Douglas County Public Health (LDCPH) and our clinicians to identify highest and best use for testing in these three areas. This funding has allowed us to create a plan and deliver testing for asymptomatic persons who live and work in Douglas County, testing for staff and residents of the Lawrence shelter, medical providers and more. We have been allotted a full total of 55,000 tests which we will be delegating to different areas and organizations within the Lawrence community based on guidance from LDCPH.
We have collaborated to create a structured plan for allocating testing and to the delegated sites, said Russ Johnson, LMH Health President and CEO. The CARES Act provided the funding that has made surveillance testing possible and we appreciate the community support as we carry out all testing plans. We are thankful for the clear and strong leadership from LDCPH and for their guidance.
Beginning next week, we will be rolling out our surveillance testing plan. Testing for public schools will begin on Nov. 30 and testing for private schools has already started. Although many people who are infected with COVID-19 become symptomatic, others do not show symptoms but can still spread the illness to others. With general population surveillance testing we strive to identify and mitigate asymptomatic cases in the community. One of our primary goals is to ensure that populations who are vulnerable or at higher risk have access to testing. LMH Health and LDCPH aim to ensure that individuals over 65 years of age, those with certain medical conditions, vulnerable populations and non-Lawrence residents are able to access a proportionate share of the tests available, the distribution of which has been determined by Public Health.
Per LDCPH, tests will be allocated based on number of constituents and the nature and frequency of each outreach event. The tests are saliva PCR tests and individuals will be required to spit into a tube in order to provide the sample. Staff will be available to answer any questions while the sample is being collected. Our goal is to provide easy access to testing back to the community to increase safety and decrease exposures from both those who may be symptomatic or not. More information about the specific testing plans will be available from each sector in the coming weeks.
We have collaborated to create a structured plan that is both fair and accurate in allocating testing and amounts of testing to the delegated sites, said Dan Partridge, director of LDCPH. We are beyond grateful for the collaboration with LMH Health to carry out a plan that strives to better the health and safety of our community.
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LMH Health, formerly Lawrence Memorial Hospital, was founded in 1921, and includes a 174-bed hospital located in Lawrence, Kansas, as well as a number of primary and specialty care clinics throughout Lawrence, Douglas County, Jefferson County and Leavenworth County. LMH Health is a community, not-for-profit hospital that serves the health care needs of the community regardless of an individual's ability to pay. LMH Health receives no tax support from the city of Lawrence or Douglas County. Dedicated to serving as a partner for lifelong health, LMH invests all excess revenues in services, equipment and facilities that further that mission.
Abstract
Tremendous progress has been made in understanding the role of T cell immunity in acute and convalescent COVID-19 infection. Here we shed light on the known unknowns of pre-existing and acquired T cell responses in relation to acute and convalescent SARS-CoV-2 infection.
The broad clinical spectrum of COVID-19 indicates widespread intraindividual differences in the host immune defense against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The underlying cause of disease heterogeneity is probably multifactorial. However, a rapid early host response is likely critical to generate control of SARS-CoV-2 viremia before spread to the lower respiratory tract and onset of damaging hyperinflammation. In this regard, the literature is full of examples where functional T cell responses can provide early control of acute viral infections, including SARS-CoV and MERS-CoV (1, 2). Although multiple studies have indicated that T cells play a role in the early immune response to SARS-CoV-2 and can generate a functional memory pool, there are still multiple unanswered questions in the field (Box 1). Here, we summarize and speculate on a specific set of questions related to T cell immunity against respiratory viral infections, with a focus on COVID-19 severity, immunity, long-term consequences, and vaccination (Fig. 1).
What do acute SARS-CoV-2-specific T cell responses in the blood tell us about contemporaneous T cell responses in the lung?
Which host and viral factors regulate the strength and efficacy of the early antiviral T cell response?
Do CD4+ T cell responses to the virus predominate over CD8+ responses in the lung as well as the blood?
Do poor CD4+ TFH responses to the virus correlate with reduced longevity of antibody responses?
Is severe COVID 19 linked to an impaired development of SARS-CoV-2-specific memory T cells?
(A) Clinical and virological factors likely to be related to the development and function of antigen-specific T cell responses against SARS-CoV-2. The impact of factors including sex, age, chronic conditions affecting immune health, viral load dynamics, degree of lymphopenia, and risk of exposure to SARS-CoV-2, on the strength and efficacy of the early antiviral T cell response remains elusive. Furthermore, some individuals experience delayed viral clearance or other symptoms for an extended period (long COVID) despite viral clearance. (B) The broad clinical spectrum of acute COVID-19 includes asymptomatic, mild, severe, and fatal outcomes. Whether convalescent individuals will be protected against SARS-CoV-2 (re)infection and the longevity of this protection remain to be determined. (C) Immunological and virological factors influence generation of SARS-CoV-2-specific T cells and may influence the clinical manifestations and quality of the induced T cell response in acute and convalescent COVID-19 patients. Here, the ability of the host to generate efficient T cell responses following SARS-CoV-2 infection are likely to be dependent on the epitopes targeted, antigen abundance, involvement of resident memory T cells (TRM) at the site of infection, presence or absence of preexisting cross-reactive T cells, and host genetic factors such as HLA type and TCR repertoire. Furthermore, the level of inflammation and amount of proinflammatory cytokines are likely to be associated with T cell activation and exhaustion and subsequent T cell memory formation. (D) The potential link between vaccination outcome in relation to T cell immunity remains to be determined.
T cells are critical to generate early control and clearance of many viral infections of the respiratory system (3). Recent studies in transgenic mouse models provided evidence that T cells are also important for viral clearance and disease resolution after SARS-CoV-2 infection (4). As such, it is not surprising that T cell activation has emerged as a hallmark of acute COVID-19; probably as a consequence of an early SARS-CoV-2-specific cellular immune response (59). Although early T cell responses may play a critical role in dampening disease severity, there are also reports describing a dysregulated and unchecked T cell activation pattern in severe cases (1012). Increased T cell activation in severe cases likely reflects increased antigen levels in the respiratory system, but whether the early T cell response reaches a state of exhaustion in subjects with severe hyperinflammation remains to be determined. Furthermore, given that COVID-19 is a disease of the respiratory tract it will be important to define if early detection of T cell activation in blood correlates with tissue-specific events. For instance, will delayed detection of SARS-CoV-2-specific T cells in blood reflect the later onset of cellular immunity in the respiratory tract or are these two compartments independent of each other in relation to disease severity?
If elicitation of an early T cell response would be beneficial to dampen COVID-19 severity, what might be the underlying causes and correlates of an early versus late onset of SARS-CoV-2-specific T cell activity? Old age and male sex are both associated with increased risk of COVID-19 complications. Interestingly, females seem to mount a somewhat stronger T cell activation following SARS-CoV-2 infection (13) and disruption of T and B cell coordination has been implicated in elderly patients with severe COVID-19 (14). On the other end of the age spectrum, decreased frequencies of IFN-+CD4+ and CD25+CD4+ T cells have been described in hospitalized pediatric patients, who have shorter lengths of stay compared with their adult counterparts (15). In conjunction with age and sex, host and viral factors probably also play a role in the early immune defense and coordination of the early SARS-CoV-2-specific T cell response. For instance, SARS-CoV-2 has mechanisms to antagonize proinflammatory signals, particularly type I IFN (IFN-I) signaling (16, 17). IFN-I proteins are key inflammatory mediators to initiate antiviral defense, from which viral evasion might lead to a delayed clearance of SARS-CoV-2 (4). This is supported by the observation that inborn errors of immunity and autoantibodies that diminish IFN-I activity are more commonly detected in patients with severe COVID-19 (18, 19). Concordantly, the early expansion and differentiation of antiviral T cells are dependent on the direct action of IFN-I. Given that activated T cells from older individuals exhibit reduced responses to IFN-I, it is tempting to speculate that higher risk elderly persons experience delayed activation of SARS-CoV-2-specific T cells that may lead to reduced clearance of the virus and exacerbated COVID-19 severity. Collectively, more data are needed from mechanistic studies in animal models as well as large cohort studies on males and females in different age groups to identify beneficial and detrimental viral and host factors that have an impact on the early T cell response against SARS-CoV-2.
Generation of memory T cells can provide lifelong protection against pathogens (20). Previous studies have demonstrated that SARS-CoV- and MERS-CoV-specific T cells can be detected many years after infection (2123). Likewise, SARS-CoV-2-specific CD4+ and CD8+ T cells are distinguished in a vast majority of convalescent donors (7, 9, 21, 2427). Studies using peripheral blood have reported stronger SARS-CoV-2-specific CD4+ than CD8+ T cell responses in most subjects. However, it is well established that CD4+ T cells experience a higher propensity to recirculate between tissues and blood than CD8+ T cells. As such, whether SARS-CoV-2-specific CD4+ T cell responses also predominate in tissues, and particularly at barrier sites close to the epithelium, needs to be confirmed through studies on the upper and lower respiratory tract.
Similar to the CD4+ T cell polarized response to many other viral infections, SARS-CoV-2-specific CD4+ T cells mainly possess a Th1 or circulating T follicular helper (TFH) cell phenotype (79, 14, 28). Circulating TFH differentiation seems to be impaired in certain patients with severe COVID-19 (11, 29) and recent analysis of postmortem lymph nodes and spleen samples showed an absence of germinal centers along with a defect in Bcl6+ TFH differentiation in deceased COVID-19 patients (30). Whether these consequences are due to sampling from postmortem patients remains unknown, but further studies are needed to clarify whether TFH cell formation is impaired by SARS-CoV-2 and could have an impact on declining antibody responses in specific convalescent donors. Furthermore, more mechanistic studies are needed to understand if memory T cells can generate protective immunity to lethal challenge with SARS-CoV-2, as previously demonstrated in SARS-CoV and MERS-CoV models (1, 2), in the presence or absence of high titers of neutralizing antibodies. Likewise, longitudinal human studies will also inform us of whether functional memory T cell responses are present many years after SARS-CoV-2 infection and correlate with protection from reinfection.
Several studies have demonstrated the presence of CD4+ and to a lesser extent CD8+ T cells recognizing SARS-CoV-2 peptides in a significant proportion of unexposed individuals (7, 21, 24, 26, 31). Mapping of SARS-CoV-2 epitopes in unexposed blood donors revealed pre-existing T cell immunity, potentially induced by seasonal human coronaviruses (HCoVs) causing common colds (27, 32). This is supported by a relatively high amino acid similarity between recognized SARS-CoV-2 epitopes and seasonal HCoVs such as HCoV-OC43, -HKU1, -229E and -NL63. The presence of cross-reactive cellular immune responses in the population generates an obstacle to the use of T cell-based assays to track SARS-CoV-2 infection rates in blood donors. Given that antibodies do not result in the same degree of cross-reactivity as T cells and are consequently easier to use in clinical diagnostic settings, serology will likely be a better readout for tracing the infection rate in the society. Nevertheless, more thorough studies are needed to better understand the full spectrum of cross-reactive versus newly-induced SARS-CoV-2-specific CD4+ and CD8+ T cell responses.
A key question in the field is whether pre-existing T cell responses influence the severity of COVID-19. Pre-existing SARS-CoV-2-specific T cells are unlikely to provide sterilizing or herd immunity but may allow the host to bypass immune evasion mechanisms, for instance evasion from IFN-I, and generate early pressure on the virus. This concept is supported by studies in mice showing that airway memory CD4+ T cells recognizing a conserved SARS-CoV epitope provided protection from related CoVs (1). Similar scenarios in which pre-existing T cells may provide earlier viral clearance and thus less severe symptoms have been proposed elsewhere (33). Here, the level of conservation between antigens may have a substantial impact on whether pre-existing T cells are beneficial or detrimental for the host. On the other hand, the concept of original antigenic sin, in which earlier induced antibody or T cell responses influence the response against future viral infections, needs further evaluation (34). If pre-existing T cells are less effective in clearing viral infection upon activation but contribute to systemic and permanent increase in inflammatory signals, it might lead to increased hyperinflammation and COVID-19 severity. In a first analysis, comparing T cell responses against SARS-CoV-2 and HCoV sequences did not find any evidence of original antigenic sin (32). Again, the level of conservation of targeted epitopes is likely to impact the outcome, and further evaluation of this concept is needed. Collectively, further animal studies and human studies done before and after SARS-CoV-2 infection are needed to define the biological relevance of pre-existing T cell responses and their role as friends or foes in host defense against SARS-CoV-2.
Resident memory T cells (TRM) are a distinct memory T cell lineage. These cells reside within tissues, do not recirculate to peripheral blood, and have been defined as local sentinels mediating rapid protection from reinfection (35). In fact, a vast majority of T cells in nonlymphoid tissues, such as the respiratory tract, are considered to be TRM (36). In terms of respiratory infections, there is a growing body of literature demonstrating that TRM can provide protection against severe pulmonary disease (37, 38). Likewise, airway CD4+ T cells can generate cross-reactive immunity between human and bat coronaviruses (1), emphasizing that cross-reactive T cells in the respiratory tract can provide protection from lethal challenge with pathogenic coronaviruses. Whether cross-reactive TRM, induced by seasonal coronaviruses, can block transmission of SARS-CoV-2 from the upper respiratory tract to the lung and thereby attenuate severe COVID-19 remains unanswered. This scenario, where TRM block the spread of viral disease from upper to lower respiratory tract, has been demonstrated in influenza A infection (37) and might account for partial immunity of secondary infection with heterologous strains (39, 40). Furthermore, whether SARS-CoV-2-specific TRM are induced after COVID-19 and whether these cells will provide protection in the long term also remains unknown (41). Although certain studies in mice have suggested that TRM in the lung are short-lived (42), there is evidence that their counterparts in the upper respiratory tract persist with minimal decay (37) and for more than a year in human lung (43). Altogether, there is currently no evidence supporting the provision of sterilizing immunity by TRM, but data presented above suggest that TRM could facilitate rapid control of upper respiratory tract SARS-CoV-2 infection, replication, and spread. In this regard, further work in animal models may provide evidence for whether local immunity mediated by TRM can achieve this type of immunity.
A substantial number of COVID-19 patients experience heterogeneous symptoms that persist over a month and onward (4446). This heterogeneous phenomenon is being referred to as long COVID and affects around 10% of all COVID-19 patients (44, 45). Many symptoms can be attributed to persistent tissue damage in severe COVID-19. Nevertheless, the fact that many individuals with milder COVID-19 symptoms also experience chronic lingering symptoms, involving the cardiovascular, nervous, and respiratory systems, indicates that persistent immune activation and/or inflammation may play a role in long COVID. Multiple mechanisms are probably involved in this condition and whether T cells play any role in long COVID is unknown. The higher incidence of long COVID in females than males, similar to autoimmune diseases (47), raises the question of whether T cells orchestrate long COVID through similar mechanisms as in autoimmune or inflammatory conditions (48, 49). One hypothetical underlying mechanism behind autoimmune-related conditions after COVID-19 could be molecular mimicry, given that HCoV-specific T cells can cross-react to myelin in multiple sclerosis patients (50). Whether SARS-CoV-2-specific T cells have the ability to react against self-antigens remains to be determined. In line with a possible effect of HLA type on COVID-19 susceptibility/severity (51, 52), we believe that larger genetic studies are needed to clarify if HLA or other immune-related genes are associated with an increased risk of developing long COVID.
Based on the uncertainty of whether cross-reactive T cells or antibodies will provide protective or long-lasting immunity to COVID-19, it will become absolutely critical to administrate a safe and effective vaccine to the population to reach broad immunity and break the negative spiral of new infections. Ongoing vaccine efforts mainly target B cells to promote the induction of neutralizing antibodies (nAbs) against SARS-CoV-2 (53, 54). Although the induction of anti-spike nAbs is the key component for an effective SARS-CoV-2 vaccine, it is well-known that T cells, and in particular TFH cells, are critical to generate antibody-producing plasma cells and long-lived memory B cells. In COVID-19 patients, high nAb titers correlated with strong CD4+ T cell responses, and the lack of functional TFH cells reacting against SARS-CoV-2 was shown to be detrimental (11, 29, 30). Preliminary results from the two major mRNA vaccine trials in humans have demonstrated potent Th1 responses (55, 56). However, previous studies have reported strong TFH responses against certain mRNA vaccines (57), and future trials should therefore include other activation induced markers, such as CD40L and/or CD200, in addition to IFN- ELISPOT assays to understand if potent B-helper mechanisms are induced by the current vaccine regimens. Other outstanding questions are whether vaccine-induced TFH responses will be equally induced in all age groups and how long these responses will persist in blood and vaccination site-draining lymph nodes. A final issue to consider is whether high quantities of vaccine-induced CD8+ T cells at local sites need to be elicited by future vaccine candidates. If the initial group of vaccines in clinical trials that are primarily focused on generating an effective nAb response provide recipients with long-standing protection, it may not be necessary to invest in such efforts. However, if problems emerge in the vaccinated population with breakthrough infections, waning antibody levels after vaccination, and/or the emergence of new viral strains, it would be wise to reconsider vaccine approaches specifically designed to induce functional CD8+ TRM responses in the upper respiratory tract.
Collective efforts have greatly enhanced our scientific understanding of T cell responses against SARS-CoV-2 but many unknowns remain to be resolved. Although it is clear that T cells play a central role in generating early control and clearance of many viral infections, their role in SARS-CoV-2 infection is only starting to be revealed. Specific T cells may even have a detrimental impact on the clinical outcome and contribute to long COVID symptoms. Currently, there is a need for deeper analysis using both animal models and longitudinal follow-up studies of large patient cohorts to define the beneficial versus detrimental aspects of SARS-CoV-2-specific T cells in acute, convalescent and vaccine settings of COVID-19.
Acknowledgments: Funding. A.C.K. was supported by the Swedish Research Council, the Karolinska Institutet, and The Center for Innovative Medicine. M.B. was supported by the Swedish Research Council, the Karolinska Institutet, the Jeansson Stiftelse, the ke Wibergs Stiftelse, the Swedish Society of Medicine, the Swedish Cancer Society, the Magnus Bergvalls Stiftelse, the Lars Hiertas Stiftelse, the Swedish Physician against AIDS Foundation, the Jonas Sderquist Stiftelse, and the Clas Groschinskys Minnesfond. Author contributions: A.C.K., M.H. and M.B. contributed to writing and drafting the illustration. A.C.K. and M.B. edited the manuscript. Competing Interests. The authors declare that they have no competing interests.
The state health officer says Washington is experiencing the fastest growth of coronavirus since March, and Thanksgiving is creating more concern.
SEATTLE Washington state health officials are continuing to warn people against hosting Thanksgiving gatherings as coronavirus cases keep rising.
During a Wednesday briefing, State Health Officer Dr. Kathy Lofy said Washington is experiencing the fastest growth of COVID-19 cases since March. If we continue on the transmission rate that we are on, Dr. Lofy said the estimate is the state will see almost 150 people admitted to hospitals everyday.
Dr. Elizabeth Wako, chief operating officer at Swedish First Hill, said her hospital is already reducing elective surgeries to make room for more COVID-19 patients.
"Just this morning, we admitted 10 patients in five hours, so that is exponential for us," said Dr. Wako.
A new national survey by the Ohio State University Wexner Medical Center found nearly two in five people report they will likely attend a gathering with more than 10 people for Thanksgiving.
"If you gather with 15 people for Thanksgiving dinner, there will be an 18% chance that one of the individuals will be infected with COVID," said Dr. Lofy.
Deputy Secretary of Health Lacy Fehrenbach added, "There's risk for further transmission. Those guests who become infected may go on to do other things the following week. They may go to a religious service. Another might work in a nursing home. A child who attended could go to school leading to outbreaks in these locations."
Dr. Mike Famulare, the principal research scientist at the Institute for Disease Modeling, found the number of COVID-19 cases rising quickly with Washington state is on track to hit 1% prevalence by Thanksgiving.
In a series of tweets, Dr. Famulare explained that could mean, 76,000 people with COVID on Thanksgiving, and between 25,000 to 40,000 people who won't yet know they are sick and bringing "#COVID19 to dinner."
"Around 450 of those people, if that comes to pass, will not make it to New Years," said Famulare. "This is growing rapidly in a way we haven't seen since the beginning of the pandemic, and what we can do about that is in our control."
Dr. Famulare said we can reverse the trend by wearing masks, practicing social distancing, and staying home as much as possible. He added that he knows it is hard to not get together for Thanksgiving, but he recommended avoiding gatherings.
WATKINS GLEN, N.Y. (WETM) Two employees at Kookalarocs Bar and Grill have tested positive for COVID-19 and a public exposure risk has been identified, according to the Schuyler County Public Health Department.
The business has since been closed and disinfected per NYSDOH guidelines after the employees worked multiple shifts during the time they were potentially contagious.
If you visited Kookalarocs Bar and Grill in the last 14 days, please:
Please get tested for COVID-19 and self-quarantine, even you dont have any symptoms. Schuyler County Public Health Director Deb Minor advised. By taking these steps, you can help protect the health of your friends, family, and our community. And if you do test positive for COVID-19, please answer when we call. Contact tracing is one of the most effective tools we currently have to slow the spread of the virus, but it only works when people are truthful about who they may have exposed to the virus.
By Monday, there had already been about two dozen people who had made appointments for the free drive-thru testing option operated by Roaring Fork Neurology in Willits, which starts today.
And that was before Dr. Brooke Allen had even advertised the new testing site which will be able to process up to 250 COVID-19 polymerase chain reaction, or PCR, saliva tests per day. While no physicians referral will be necessary, appointments will be required and can be made via rfvcovidtest.com.
Allen, like the testing program rolled out in the school system at the start of the month and by the city and county through the end of 2020, took advantage of unused CARES Act funding to create robust, communitywide testing at least through the end of the year.
Whatever the reason is [for testing], [its] no questions asked and at no cost to them, Allen said Monday. The state is going to run out of CARES Act money at the end of December, and we saw an opportunity to make good use of those funds.
Allens practice has already been offering testing, but this is the first time she and her team have been able to expand the service to anyone seeking it.
To that effect, Roaring Fork Neurology has been partnering with MicroGenDx, a Texas-based testing company, to fulfill its patient needs since April. So when it became clear broader testing was feasible at least through the end of the year Allen didnt see any reason to not continue the relationship.
Theyre a company that has a lot of experience with testing, and they provide the saliva PCR test with about a 48-hour turnaround time from the time a person gets a test to the time we get the result, and can share it with the client, she said. Weve had such a great experience with them since April.
MicroGen like the Los Angeles-based vendor Curative, which the Aspen School District and Pitkin County utilize in their 2020 testing programs has a contract with the Colorado Department of Public Health and Environment. For the local provider and patient, that means no cost is passed to the patient. As long as a test falls within the medically necessary requirements outlined by the CARES Act that is, symptomatic or with a known exposure to a COVID-19 case no patient should see a bill, though an insurance company may. For those without insurance, tests are actually billed to the federal government, so long as they fit within the CARES Act parameters.
MicroGen then gives some of that money to my team, and we set up a testing site. Weve set up one at the El Jebel, which is at the Eagle County Community Center, Allen explained.
But, shes made it clear, El Jebel is hardly the only backyard available to such sites.
We have meetings later this week to set up other sites throughout the valley. Were hopeful were going to get another site in Glenwood and, really, anywhere someone thinks there could be a site with minimal red tape, she said, adding that a sometimes unassuming, would-be testing site comes with actual homeowners association fees and the like, making the implementation of such an operation not feasible.
Sometimes you get into HOA dues and HOA liability insurance issues and all this, she allowed.
Still, Allen said that shes been in close contact with Pitkin County throughout the process.
We work with Pitkin County constantly. We did a large group of testing for a presumed outbreak in Pitkin County, she said. We work with them all the time, and we had definitely said, If this [other] partnership doesnt work out, were happy to put a site in wherever you want we just need three days notice.
She added that municipalities like Pitkin County are stretched to their limit as case numbers and incident rates continue to rise, requiring additional public health restrictions. Those layers add additional responsibilities on local governments not immediately thrust on private medical practices, Allen emphasized.
Pitkin is still doing a great job, she said. Its so important for our community even though theres COVID fatigue its so important that you always wear a mask. It makes such a difference. My office has been open: we wear masks, were all together. We dont have cases here. Wearing a mask works.
PHOENIX - As the nation gets closer to Thanksgiving amid the ongoing COVID-19 pandemic, many people are planning to travel or hold get-togethers with family and friends, and that isone of the big reasons why there's a rush on COVID-19 tests in the Valley.
According to doctors, besides the holiday season, there is another reasonwhy so many people are now getting testing, and that is because the state is seeing a surge in the number of new COVID-19 cases, people are getting concerned and they want to be on the safe side.
"Getting a lot more calls from people with kids in schools who had a scare and now needing to have their child tested,"said RayYoung with Terros Health.
Young says even though they are seeing a large increase in testing, there isnt a backlog, and testing wait times at his facilities are now down to about two to three days.Thats in comparison to the two week wait times from back in the spring months.
"The labs are better equipped to handle them,"said Young."I hear they are doing about 15,000 tests a day."
Young says one of the reasons why so many people are now deciding to get tested, some of them asymptomatic, is because of the holidays.
"Were hearing people are trying to decide whether to get together to go on these holiday trips," said Young.
Dr. Jeffrey Weber, Medical Director for InfusAble Care says he is seeing a similar trend at his office in Scottsdale, where they just started offering rapid 15-minute tests.
"The ability to make a more informed decision about what you are doing for the holidays. You can feel more safe and make a more informed decision about whats right for you," said Dr. Weber.
Whatever peopledecide to do this holiday season, Young says its important to practice kindness, as well as hygiene.
"Just be kind to one another," said Young. "Take care of one another. Were all experiencing this together and lets help one another out."
Another four Mainers have died as health officials on Wednesday reported 158 new coronavirus cases across the state.
Wednesdays report brings the total number of coronavirus cases in Maine to 9,519. Of those, 8,599 have been confirmed positive, while 960 were classified as probable cases, according to the Maine Center for Disease Control and Prevention.
The agency revised Tuesdays cumulative total to 9,361, down from 9,363, meaning there was a net increase of 156 over the previous days report, state data show. As the Maine CDC continues to investigate previously reported cases, some are determined to have not been the coronavirus, or coronavirus cases not involving Mainers. Those are removed from the states cumulative total. The Bangor Daily News reports on the number of new cases reported to the Maine CDC in the previous 24 hours, rather than the increase of daily cumulative cases.
New cases were reported in Androscoggin (17), Cumberland (31), Franklin (7), Hancock (11), Kennebec (16), Knox (1), Lincoln (4), Oxford (4), Penobscot (18), Piscataquis (3), Sagadahoc (1), Somerset (5), Waldo (4), Washington (3) and York (29) counties, state data show. Information about where four additional cases were reported wasnt immediately available
Only one county Aroostook reported no new cases.
The seven-day average for new coronavirus cases is 191.7, up from 190 a day ago, up from 164.7 a week ago and up from 30.9 a month ago.
Since the latest surge in virus transmission began a little more than three weeks ago, Maine has seen nearly 3,500 new cases and 24 deaths. It took Maine until early July to record as many cases, four months after health officials confirmed the virus presence here.
Health officials have warned Mainers that forceful and widespread community transmission is being seen throughout the state. Five counties are seeing high community transmission: Franklin, Knox, Somerset, Waldo and Washington counties.
There are two criteria for establishing community transmission: at least 10 confirmed cases and that at least 25 percent of those are not connected to either known cases or travel.
The statewide death toll now stands at 170. The latest deaths involved a woman in her 90s from Knox County, a man in his 80s from Kennebec County, a woman in her 80s from York County and a man in his 90s from York County. Nearly all deaths have been in Mainers over age 60.
So far, 600 Mainers have been hospitalized at some point with COVID-19, the illness caused by the coronavirus. Of those, 85 people are currently hospitalized, with 30 in critical care and 10 on ventilators.
Meanwhile, 204 more people have recovered from the coronavirus, bringing total recoveries to 7,229. That means there are 2,120 active confirmed and probable cases in the state, which is down from 2,172 on Tuesday. Its the first decline in the active case count Maine has seen since the latest surge began in late October.
A majority of the cases 5,654 have been in Mainers under age 50, while more cases have been reported in women than men, according to the Maine CDC.
As of Wednesday, there have been 776,159 negative test results out of 787,840 overall. About 1.4 percent of all tests have come back positive, Maine CDC data show.
As of Tuesday, there have been 230 cases of COVID-19 in students at Pre-K-12 schools in the last 30 days 205 confirmed and 25 probable. Fourteen schools currently have open outbreaks with the most cases being nine at Thornton Academy in Saco.
There are currently 43 known cases among students, faculty and staff in the University of Maine System out of 30,000 individuals, according to UMS spokesperson Dan Demeritt.
Thirty-one cases are at UMaine with two new cases involving commuter students and one employee completing isolation; One case is associated with University of Maine at Augusta; One case is associated with University of Maine at Machias; One case was announced at the University of Maine at Presque Isle involving a student living in a residence hall through the schools asymptomatic testing program; And nine cases are associated with the University of Southern Maine with one non-resident student completing isolation.
Five of the 43 cases at UMS are residence hall students with two at UMaine, one at UMPI and two at USM.
On Tuesday, officials at the University of Maine at Presque Isle announced that the first known cases of COVID-19 at the school was declared a false positive. The Vault PCR test that the university uses has a 1 percent false positive rate nationally.
The coronavirus has hit hardest in Cumberland County, where 3,361 cases have been reported and where the bulk of virus deaths 70 have been concentrated. Other cases have been reported in Androscoggin (1,248), Aroostook (88), Franklin (170), Hancock (188), Kennebec (619), Knox (172), Lincoln (117), Oxford (252), Penobscot (533), Piscataquis (28), Sagadahoc (123), Somerset (366), Waldo (199), Washington (159) and York (1,890) counties. Information about where an additional six cases were reported wasnt immediately available.
As of Wednesday evening, the coronavirus had sickened 11,485,176 people in all 50 states, the District of Columbia, Puerto Rico, Guam, the Northern Mariana Islands and the U.S. Virgin Islands, as well as caused 250,029 deaths, according to Johns Hopkins University of Medicine.
Several Republicans, including lawmakers who have had Covid-19, continue to resist wearing masks elsewhere in the Capitol, and a nasty spat broke out about the practice on Monday on the normally decorous Senate floor.
Late last week, House Democratic leaders abruptly transformed an elaborate dinner in Statuary Hall for their new members into a grab-and-go meal after facing a backlash online and internally for hosting such an event when most Americans are being warned to curtail or cancel holiday plans. And during orientation for new lawmakers which had already been largely subdued because of the virus Marjorie Taylor Greene, a QAnon-backing Republican, proudly announced in the middle of a discussion of pandemic safety that she had denounced face coverings.
It is a dynamic that bodes poorly for attendance in the waning days of the 116th Congress. On Tuesday, the absence of Mr. Grassley and Mr. Scott temporarily stalled the confirmation of Judy Shelton, Mr. Trumps Fed nominee, after Republicans fell short of the support necessary to advance to a final vote.
Theres this kind of macho, Well, Im not afraid of Covid thing going on, said Senator Brian Schatz, Democrat of Hawaii, who has one of the longest congressional commutes and has instructed his entire staff to work remotely. We have to run the government thats our obligation. Our obligation is not to show that were personally unafraid, because we have to pass legislation to address this crisis, and were no good to anybody if were sick or quarantining.
The partisan divisions were further underscored by a tense exchange on Monday evening between Senator Sherrod Brown, Democrat of Ohio, and Senator Dan Sullivan, Republican of Alaska, while Mr. Sullivan was presiding over the chamber.
When Mr. Brown rose to speak, he asked Mr. Sullivan, whose mask was off and lying on the desk in front of him, to please wear a mask, in part to protect the staff members required to sit on the dais just below, at a distance closer than the six feet recommended for proper distancing.
I dont wear a mask when Im speaking, like most senators, shot back Mr. Sullivan, who wears a mask around the Capitol but removes it to speak on the floor. I dont need your instruction.
This story will be updated.
Another Mainer has died as health officials on Thursday reported 217 new coronavirus cases across the state.
Thursdays report brings the total number of coronavirus cases in Maine to 9,734. Of those, 8,732 have been confirmed positive, while 1,002 were classified as probable cases, according to the Maine Center for Disease Control and Prevention.
The agency revised Wednesdays cumulative total to 9,517, down from 9,519, meaning there was a net increase of 215 over the previous days report, state data show. As the Maine CDC continues to investigate previously reported cases, some are determined to have not been the coronavirus, or coronavirus cases not involving Mainers. Those are removed from the states cumulative total. The Bangor Daily News reports on the number of new cases reported to the Maine CDC in the previous 24 hours, rather than the increase of daily cumulative cases.
New cases were reported in Androscoggin (21), Aroostook (1), Cumberland (50), Franklin (9), Hancock (4), Kennebec (11), Knox (2), Lincoln (10), Oxford (15), Penobscot (39), Sagadahoc (5), Somerset (5), Waldo (2), Washington (10) and York (31) counties, state data show. Information about where an additional two cases were reported wasnt immediately available.
Only one county Piscataquis reported no new cases.
The seven-day average for new coronavirus cases is 194.3, up from 193.3 a day ago, up from 173.1 a week ago and up from 31 a month ago.
Thursdays report comes as the Maine CDC announced it will no longer investigate suspected coronavirus cases until confirmed by testing. That could result in fewer probable cases being reported, but Director Nirav Shah said Wednesday it doesnt mean the virus poses a lesser risk.
That move is partly to cope with a more than three-week-long surge in new coronavirus cases and as the flu season approaches when Mainers may start to develop similar symptoms to the coronavirus.
Thursday also marked the fifth time in 10 days when more than 200 new cases have been reported.
Health officials have warned Mainers that forceful and widespread community transmission is being seen throughout the state. Five counties are seeing high community transmission: Franklin, Knox, Somerset, Waldo and Washington counties.
There are two criteria for establishing community transmission: at least 10 confirmed cases and that at least 25 percent of those are not connected to either known cases or travel.
The latest death involved a Kennebec County resident, bringing the statewide death toll to 171. Nearly all deaths have been in Mainers over age 60.
So far, 613 Mainers have been hospitalized at some point with COVID-19, the illness caused by the coronavirus. Information about those who are currently hospitalized wasnt immediately available.
Meanwhile, 174 more people have recovered from the coronavirus, bringing total recoveries to 7,403. That means there are 2,160 active confirmed and probable cases in the state, which is up from 2,120 on Wednesday.
A majority of the cases 5,806 have been in Mainers under age 50, while more cases have been reported in women than men, according to the Maine CDC.
As of Wednesday, there have been 776,159 negative test results out of 787,840 overall. About 1.4 percent of all tests have come back positive, the most recently available Maine CDC data show.
The coronavirus has hit hardest in Cumberland County, where 3,415 cases have been reported and where the bulk of virus deaths 70 have been concentrated. Other cases have been reported in Androscoggin (1,269), Aroostook (89), Franklin (179), Hancock (192), Kennebec (629), Knox (174), Lincoln (174), Oxford (267), Penobscot (573), Piscataquis (28), Sagadahoc (128), Somerset (370), Waldo (200), Washington (170) and York (1,921) counties. Information about where an additional three cases were reported wasnt immediately available.
As of Thursday morning, the coronavirus had sickened 11,531,451 people in all 50 states, the District of Columbia, Puerto Rico, Guam, the Northern Mariana Islands and the U.S. Virgin Islands, as well as caused 250,548 deaths, according to Johns Hopkins University of Medicine.
Correction: An earlier version of this report misstated the number of new cases reported in Androscoggin County over the previous 24 hours.
Several forms of government aid have been granted to Americans and their businesses in response to the pandemic. But anyone who recently received their property tax bills in Florida they started going out at the end of October may have noticed there were no adjustments made because of the coronavirus.
So is property tax relief a possibility, and if so, who would get it, and when?
Pinellas Property Appraiser Mike Twitty spoke with us to answer those questions, which he said are being discussed by every property appraiser both around Tampa Bay and throughout the state. The conversation has been edited for length and clarity:
Lets start with the basics. Property owners in Pinellas and throughout Florida are starting to get their property tax bills for the year, and some may be wondering why theres no pandemic relief in them. What is the explanation for that?
The explanation is that property taxes are always paid in arrears, meaning youre paying after the fact. So when we value properties, its always based on an effective date of January 1 for that tax year. So that predated the pandemic. The first two cases of coronavirus were reported in Florida in early March. So those values were effectively already set prior to that date because were always analyzing data from the prior year. We were using 2019 data to set that January 1, 2020 value.
But youve mentioned that your office is talking with some state officials to get sales and bed tax data to determine who might be eligible for a discount in next years taxes. Can you tell me more about that, and what types of property owners that might affect?
We already do receive sales and bed tax data, but its not as regular as we would like to really analyze impacts to particular commercial property owners and businesses. So if we have (more of) that data, well be able to better see who, essentially, the winners and losers were during the course of the pandemic.
We have a pretty good gut feel as to who those are, but we want to actually see real numbers to back it up. So Ive been in discussions with the governors office and the Department of Revenue in order to allow that flow of information. The other thing that were trying to do is encourage all of our income-producing commercial property owners and businesses to provide their profit and loss statements for 2019 versus 2020 so that we have tangible evidence showing their potential impact at their location or their business type.
We have two different things to look at. We have not only real estate values, we also have tangible personal property values, and that would be all your business equipment. Some business owners may be renters, so they dont own the real estate, but they own equipment thats in that location, and theyre paying tangible taxes on those items. So we would like to see their information as well to help with potential relief efforts there.
As far as identifying the property types were most concerned about on the commercial side, hospitality is a big one. So your bars, your restaurants, your hotels, your theaters, live music venues. And then your local multi-tenant office and retail. We do foresee there could be some impacts to multifamily (apartment buildings). We dont think theyll be as deep but we do know that there are some issues there with with tenants' ability to pay.
In order to provide relief based on all that information youre gathering, would that require action from the Legislature?
It could.
Lets back up. A tax bill is derived from two variables. You have value and you have tax rate, or millage. The tax rates are set by your taxing authorities, which are your county, your various municipalities, your school board ... So those rates against value are what create peoples tax bills.
With that in mind, the only piece we have control over in the property appraisers office is the value piece. So if its one of these property types that were talking about that is impacted in a manner that the value decreases for January 1, 2021, essentially, there would be automatic relief built in by value reduction.
A lot of residential (value) is likely to increase, because we have not seen a downturn in residential whatsoever. The pandemic has actually created a shortage of supply through most of Florida. Supply is down to the tightest amount weve likely ever seen, the lowest supply Ive seen in my 30 years in real estate here in Pinellas County.
So that has obviously resulted in prices moving up. In those situations, then, any sort of relief would have to come from in that other side of the equation, that other variable, which would be the millage. So that would have to come from the taxing authorities, or you have to have legislative action that would grant certain property owners some form of a credit.
Theyve done that for hurricanes. They have had a formula (to subtract) the number of days that you couldnt occupy your residence because you were displaced by the hurricane. This is tougher to quantify, because you dont see necessarily physical damage to justify it. It would have to be vetted in a different manner. Thats why I think the importance of having profit-loss statements and things like that, to justify the fact that people have been impacted at that level.
So youre saying that for single-family homeowners to receive a tax break next year, that will likely require government action, since their property values are going up?
Right. Thats a generality, but overall, the market is on an upswing on the residential side.
Is there anything else you think is important to know ?
If people want more information, they can go to our website, pcpao.org. On our homepage, we have a little section that says, communicating with our office, and theres a link there for important information regarding COVID-19 and property values. Theres a little infographic that explains the importance of January 1, when relief would potentially be considered and it has an FAQ.
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